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Medical Management of Epiglottitis.

Regina A E Dowdy1, Bryant W Cornelius2

  • 1Resident, Division of Oral and Maxillofacial Surgery and Dental Anesthesiology, The Ohio State University, Columbus, Ohio.

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|July 8, 2020
PubMed
Summary

Epiglottitis, a bacterial infection causing airway swelling, is increasingly seen in adults due to the Haemophilus influenzae B (HiB) vaccine

Keywords:
Emergent tracheostomyEpiglottitisStridorTotal airway obstruction

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pediatrics

Background:

  • Epiglottitis is a bacterial infection causing inflammation and swelling of the epiglottis and surrounding areas.
  • Historically prevalent in children aged 2-6, adult cases are rising due to the Haemophilus influenzae B (HiB) vaccine's impact on pediatric incidence.
  • Key symptoms include fever, sore throat, muffled voice, drooling, tripod positioning, and stridor, indicating potential airway obstruction.

Purpose of the Study:

  • To review the current understanding of epiglottitis, focusing on its changing epidemiology and clinical presentation.
  • To emphasize the importance of prompt airway assessment and management in suspected epiglottitis cases.
  • To highlight the necessity of intensive care unit admission for monitoring patients with epiglottitis.

Main Methods:

  • Review of clinical presentations and diagnostic considerations for epiglottitis.
  • Discussion of the role of imaging in diagnosis, stressing that it should not delay airway management.
  • Emphasis on the immediate evaluation by airway specialists and ICU admission.

Main Results:

  • The incidence of epiglottitis is shifting, with an increasing number of adult cases observed.
  • Clinical signs such as stridor and muffled voice are critical indicators of impending airway compromise.
  • Radiographs can aid diagnosis but securing the airway remains the priority.

Conclusions:

  • Prompt evaluation by an airway specialist is crucial for patients presenting with epiglottitis symptoms.
  • Airway management should take precedence over diagnostic imaging if obstruction is suspected.
  • All patients diagnosed with epiglottitis require admission to the intensive care unit for close monitoring and management.