Acute Supraglottitis in Pediatric Patients-An Emerging Disease?

Supraglottitis is an acute inflammation of the epiglottis and entire supraglottic structures, and a potential cause of upper airway obstruction in children. However, data on pediatric supraglottitis remain very limited. This study aims to describe the epidemiological, clinical, laboratory, and microbiological characteristics of pediatric supraglottitis, with particular emphasis on identifying its various etiologies.

We conducted a retrospective review of medical records of children admitted to the pediatric intensive care unit of a tertiary pediatric hospital with a diagnosis of supraglottitis, between 2004 and 2024. Patients were subsequently categorized into two groups: with adenovirus-associated supraglottitis and supraglottitis attributable to other etiologies.

A total of 32 children with supraglottitis were included. The incidence increased by 330% between the first and second decades of the study. The most common presenting features were fever, stridor, and dyspnea. Invasive mechanical ventilation was required for 53% of patients, while 9% received noninvasive ventilation. A viral etiology was identified in 19/30 (63%) patients, with adenovirus being the most frequently detected pathogen (10 of 19 cases). Bacterial pathogens were isolated from sputum cultures in 16/17 patients, most commonly Streptococcus group A. Children with adenovirus-associated supraglottitis had significantly higher fever and C-reactive protein levels.

In this pediatric supraglottitis cohort, incidence increased over time. Respiratory viral infections were evident in most cases, with adenovirus identified as the most common pathogen.