Acute klebsiella epiglottitis: considerations for initial antibiotic coverage

Area of Science:

• Infectious Diseases
• Bacteriology

Background:

• Acute epiglottitis is a serious upper airway infection.
• Traditionally, Hemophilus influenzae was the primary cause, but etiologies are evolving.

Observation:

• A case of acute epiglottitis in an adult patient caused by Klebsiella pneumoniae is presented.
• The patient initially received ampicillin but showed no improvement.

Findings:

• Treatment failure with ampicillin necessitated cephalosporin therapy and surgical drainage.
• Klebsiella pneumoniae demonstrated resistance to ampicillin.

Implications:

• Increased ampicillin resistance in Hemophilus influenzae and other pathogens like Staphylococcus aureus and gram-negative rods necessitate alternative treatments.
• Early consideration of newer cephalosporins, such as moxalactam or cefamandole, is advised for empirical treatment of adult epiglottitis.