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Published on: September 2, 2011
Acute epiglottitis. An 18-year experience in Rhode Island
M F Mayo-Smith1, J W Spinale, C J Donskey
1Section of General Medicine and Primary Care, Veterans Affairs Medical Center, Manchester, NH 03104, USA.
Chest
|December 1, 1995
Summary
Epiglottitis incidence has shifted from children to adults. While airway obstruction factors remain, some adults can be treated without immediate artificial airways.
Area of Science:
- Infectious Diseases
- Epidemiology
- Otolaryngology
Background:
- Epiglottitis, a serious upper airway infection, historically affected children predominantly.
- Changes in causative agents and vaccination have influenced its epidemiology.
Purpose of the Study:
- To investigate the 18-year trends in epiglottitis incidence, clinical features, management, and outcomes.
- To identify factors influencing epiglottitis presentation and severity.
Main Methods:
- A case series design was employed.
- Data were collected from Rhode Island hospital discharges and the State Medical Examiner's log (1975-1992).
- Analysis included incidence by age, clinical presentation, diagnostic findings, management, and patient outcomes.
Main Results:
- A total of 407 cases were identified (134 children, 273 adults).
- Pediatric epiglottitis incidence dramatically decreased, while adult cases significantly increased.
- Factors associated with airway obstruction included respiratory distress, stridor, drooling, and Haemophilus influenzae bacteremia.
Conclusions:
- Epiglottitis epidemiology has shifted, now predominantly affecting adults.
- Adult epiglottitis cases often present with less severe symptoms and reduced H. influenzae infection rates.
- Careful patient selection may allow for safe treatment of some adults without immediate artificial airway intervention.
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