Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Epiglottitis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1985

Croup and epiglottitis: a radiologic study.

Because of the controversy regarding the benefits of the lateral neck and chest radiographs in the evaluation of croup and epiglottitis, a two-part retrospective study was initiated. Part I consisted of a retrospective chart review of 44 patients with a final diagnosis of croup and epiglottitis. Part II consisted of the 42 lateral neck and chest x-rays from patients in part I presented to six radiologists who knew only the patients age and the history of respiratory distress. Two hundred forty-six responses were obtained. The results of the part I study showed that 64% of patients with documented epiglottitis had a positive radiologic diagnosis. Only 33% of patients with croup had a positive radiologic diagnosis and importantly 27% had a diagnosis of possible epiglottitis. The results of part II showed 38% of the documented epiglottitis patients had a positive lateral neck radiograph. The croup patients had a lateral neck and/or chest x-ray positive in 38%. Of interest, 24% had readings consistent with possible epiglottitis. Based on this two-part study, it is our conclusion that the lateral neck and chest x-ray may be unreliable and inaccurate in the diagnosis of croup and epiglottitis. Caution and good clinical judgement should be utilized when interpreting these x-rays.

Adult↗
PubMed1994

Disappearance of epiglottitis during large-scale vaccination with Haemophilus influenzae type B conjugate vaccine among children in Finland.

Surveillance of blood-culture-proven epiglottitis was conducted in Finland from 1985 through 1992. Among children (< 16 years), all bacteria causing epiglottitis, and among adults, Haemophilus influenzae were included. H influenzae type b (Hib) caused 226 (97%) of cases among children. Among adults with H influenzae epiglottitis (total of 20), 19 were caused by Hib. In 1986, vaccine trials with Hib-conjugate vaccines started in Finland, with vaccination coverage of 94% to 98% of infants. Vaccinations did not yet have an effect on the occurrence of epiglottitis in 1985 or 1986 when the annual incidence among children was 5.3/100,000, among those less than 5 years of age was 13.2/100,000, and among adults was 0.08/100,000. In 1987 through 1992 the proportion of vaccinated children increased steadily while the incidence of Hib epiglottitis decreased from 50 to 60 cases seen annually in 1985 and 1986 to 2 cases in 1992. There was no increase in the occurrence of epiglottitis caused by other pathogens. In conclusion, there is now a safe and efficient way to prevent the majority of epiglottitis cases among children with the new Hib-conjugate vaccines.

Adolescent↗
PubMed1988

Differentiation of epiglottitis from laryngotracheitis in the child with stridor.

To identify which clinical findings serve to differentiate acute epiglottitis from laryngotracheitis and also to evaluate the role of direct inspection of the epiglottis in the evaluation of children initially thought to have laryngotracheitis, we prospectively evaluated 155 children presenting to the emergency room with acute stridor. Three of the findings on physical examination were associated with epiglottitis: absence of spontaneous cough, drooling, and agitation. The diagnosis assigned prior to inspection of the epiglottis was incorrect in two of six patients with epiglottitis and in three of 149 patients with laryngotracheitis. The diagnosis made after inspection was correct in all 155 patients. Minor complications of inspection were seen in seven patients with laryngotracheitis. No complications were seen in the children with epiglottitis. We conclude that drooling, agitation, and absence of cough are predictors of epiglottitis, but clinical findings alone cannot exclude epiglottitis in every child who appears to have laryngotracheitis. When laryngotracheitis is the suspected diagnosis, inspection of the epiglottis by a pediatrician in a hospital emergency room is an effective aid to the evaluation of the child with acute stridor.

Acute Disease↗
PubMed1996

Differing antibody responses to Haemophilus influenzae type b after meningitis or epiglottitis.

Two common forms of invasive disease due to Haemophilus influenzae type b (Hib) are epiglottitis and meningitis. It is not known why some children develop epiglottitis and others meningitis. To examine the hypothesis that epiglottitis occurs in children who may have been previously exposed to Hib, and who would therefore exhibit a more vigorous antibody response in convalescence, we measured levels of antibody to Hib capsule in 92 children. Geometric mean convalescent-phase IgG, IgA, IgM and total antibody levels were significantly higher in 45 children with epiglottitis than in 47 with meningitis, even after adjustment for age differences (mean total antibody, 95% confidence intervals: meningitis 0.38, 0.34-0.43; epiglottitis: 2.25, 2.0-2.54 micrograms/ml). However, contrary to previous reports, a poor antibody response was only observed in a minority of children with meningitis; the antibody response of the majority was indistinguishable from that observed in children with epiglottitis.

Acute-Phase Reaction↗
PubMed2002

[Epiglottic abscess as a rare reason for airway obstruction in adults].

Acute epiglottitis in adults is a potentially life-threatening disease of increasing incidence. Although pharyngitis is the most common cause of sore throat in the adult, acute epiglottitis must be considered in the differential diagnosis when there is unrelenting throat pain and minimal objective signs of pharyngitis. We report the case of a 45-year old man with acute epiglottitis and occlusion of the upper airways due to an epiglottic abscess. A brief discussion of the diagnosis and treatment of adult epiglottitis is presented. Patients with acute painful dysphagia should be considered to have epiglottitis until the diagnosis is proven. Early diagnosis and aggressive airway management can be life saving.

Abscess↗
PubMed1995

Acute epiglottitis in children: results of a large-scale anti-Haemophilus type B immunization program.

The incidence of acute epiglottitis in children is declining in the province of Quebec, Canada. In 1988, a PRP-D anti-Haemophilus type B vaccine was introduced into the routine vaccination schedule of 18-month-old children. A substantial reduction in the occurrence of acute epiglottitis was perceived by clinicians. Since 1992, improved new vaccines (PRP-T, HbOC, PRP-OMPC), given to 2-month-old infants, have been expected to increase the efficacy of the immunization program. The impact of the immunization program on preventing acute epiglottitis was verified using a provincial database system called Med-Echo. In the presumably vaccinated target population (0 to 6 years old), 15 children suffered acute epiglottitis in 1993, whereas 97 cases were reported on the average for each yearly period from 1984 to 1987, just before the program's inception. Thus, the incidence of acute epiglottitis in preschoolers was reduced to 15.4% of its former level. The overall efficacy of the immunization program in preventing acute epiglottitis, therefore, is estimated to be 84.6%.

Acute Disease↗
PubMedDate not supplied

Epiglottic abscess.

BACKGROUND: Epiglottitis is more commonly seen in children less than 6 years of age, although this entity has also been well described among adults. A coalescence of infection of the epiglottis, or epiglottic abscess, has been infrequently reported in series of epiglottitis. Risk factors for epiglottic abscess include adult age at onset, diabetes, and the presence of a foreign body. METHODS: Case study. RESULTS: We present a case of a woman with a 4-day history of febrile illness, odynophagia, and an altered voice. Clinical examination and computed tomography (CT) demonstrated an epiglottic abscess. The patient underwent direct laryngoscopy, intubation, drainage of abscess, and intravenous antibiotics. CONCLUSIONS: The diagnosis of epiglottic abscess should be considered in adult patients initially seen with odynophagia and dysphonia. Principles of treatment include airway management, antibiotics, and surgical drainage.

Abscess↗
PubMed1996

Epiglottitis in adults and children in Olmsted County, Minnesota, 1976 through 1990.

OBJECTIVE: To compare the initial clinical manifestations and sequelae of epiglottitis among children and adult residents of Olmsted County, Minnesota. MATERIAL AND METHODS: We conducted a population-based retrospective cohort study of all Olmsted County residents with the diagnosis of epiglottitis during the 15-year period from Jan. 1, 1976, through Dec. 31, 1990. RESULTS: From 1976 through 1990, 41 residents (20 children and 21 adults) of Olmsted County were diagnosed with epiglottitis. (One case in an adult was first diagnosed at autopsy and was included only in the incidence rates and analysis of seasonal and secular trends.) Children had a mean annual incidence rate of 4.25 per 100,000, whereas the rate in adults was 2.18 per 100,000. The age- and sex-adjusted incidence of epiglottitis decreased during the study period from 4.94 per 100,000 during 1976 through 1980 to 2.08 per 100,000 during 1986 through 1990. No seasonal effect was detected in adults or children. At initial assessment, adults tended to have pharyngeal symptoms (sore throat and odynophagia), cervical adenopathy, and ear pain, whereas children most often had respiratory (stridor, dyspnea, and retractions) and laryngeal symptoms. Proportionately, more children than adults received artificial airway support and had associated pneumonia. One death occurred in an adult, in whom the diagnosis was made at autopsy. CONCLUSION: The incidence of epiglottitis has decreased significantly in recent years. Children and adults have considerably different initial manifestations of epiglottitis.

Adolescent↗
PubMed1989

Epiglottitis in infants less than two years of age.

A retrospective review of 41 children less than two years of age was conducted to characterize the clinical presentation of epiglottitis in this young age group. Up to 25% of all cases of epiglottitis occur in children less than two years of age. The clinical presentation of patients in this young age group is variable. Signs and symptoms not routinely described in children over two years of age with epiglottitis but often observed in infants with epiglottitis include the absence of fever, the presence of only low grade fever, a significant history of antecedent URI, and a prominent "croupy" cough. These same features are often noted in children with the viral croup syndrome. A diagnosis of this life-threatening illness may be made promptly through an awareness of the presenting findings observed in infants. Young infants with epiglottitis can be safely managed with short-term nasotracheal intubation.

Airway Obstruction↗
PubMed1996

Epiglottitis: a 9-year case review.

A retrospective chart review of all cases of suspected epiglottitis from 1985 to 1993 at Arkansas Children's Hospital identified 29 patients treated for epiglottitis during this 9-year period. Review of the immunization status of these patients showed 72% without Hib vaccination, 11% who had initiated the Hib series, and 17% with unknown immunization status. The incidence of epiglottitis declined over the duration of the study with 0.61/1,000 admissions in 1985, 0.27 in 1986, 1.42 in 1987, 0.9 in 1988, 0.39 in 1989, 0.0 in 1990, 0.35 in 1991, 0.0 in 1992, and 0.0 in 1993. Comparing the years before available conjugate vaccine--1985 to 1988--with the years after conjugate vaccine--1989 to 1993--shows a significant change in the incidence of epiglottitis. With increasing populations of susceptible children receiving Hib immunization, Hib epiglottitis may become a vanishing entity.

Adolescent↗
PubMed1988

Serum and salivary antibody responses to non-capsular Haemophilus influenzae antigens in children with meningitis and epiglottitis.

Serum IgG, IgA and IgM antibody and salivary IgA antibody concentrations to non-capsular Haemophilus influenzae antigens were measured in 13 children with H. influenzae type b meningitis and in 15 children with epiglottitis. Most had detectable serum IgG and IgM antibody at presentation but significantly fewer patients with meningitis had serum IgA antibody at presentation (P less than 0.05). Serum antibody concentrations had risen significantly by 3 weeks after presentation in patients with epiglottitis only. Convalescent serum IgG antibody concentrations against these antigens were higher in younger children with epiglottitis. Salivary IgA antibody to H. influenzae was detectable at presentation in all children with epiglottitis and in 12 of 13 with meningitis. Salivary antibody concentrations did not differ significantly between the two patient groups at presentation, although patients with meningitis had higher salivary IgA antibody concentrations than 10 children of similar age with bronchiolitis (P less than 0.02). There was no association between the presence of salivary antibody and low concentrations of convalescent serum antibody. The rise in convalescent serum antibody concentrations to non-capsular H. influenzae antigens only in children with epiglottitis is similar to findings for antibody to capsular polysaccharide. However, this rise was greater for IgG in younger patients, and the low titre of convalescent serum antibody in patients with meningitis was not associated with higher titres of IgA antibody in secretions as described by others for polysaccharide antibody. These findings suggest that the poor serum antibody response to these antigens in patients with meningitis is independent of age and is not due to mucosal induction of systemic tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗
PubMed1994

Successful treatment of epiglottitis with two doses of ceftriaxone.

Epiglottitis in childhood is caused by Haemophilus influenzae type b. The usual antibiotic treatment at the Royal Children's Hospital, Parkville, Victoria is a five day course of chloramphenicol. Increasingly, third generation cephalosporins are being used to treat invasive H influenzae type b infections and preliminary data suggest that they can be used successfully for epiglottitis. In a prospective, randomised trial, the efficacy of a short course (two days) of ceftriaxone was compared with that of five days of chloramphenicol for the treatment of epiglottitis. The ability of these treatment regimens to eradicate H influenzae type b from the throat was also studied. Fifty five children were enrolled over an 18 month period. Epiglottitis was diagnosed clinically and confirmed on inspection of the epiglottis at direct laryngoscopy. Fifty three (96%) of 55 patients had H influenzae type b detected from at least one site: 44/52 (85%) from blood cultures, 41/47 (87%) from throat swab, and 6/8 (75%) as H influenzae type b urinary antigen. Children were randomised to receive either ceftriaxone 100 mg/kg intravenously followed by a single dose of 50 mg/kg 24 hours later (28 patients), or chloramphenicol 40 mg/kg intravenously, then 25 mg/kg eight hourly for five days, intravenously then by mouth (27 patients). All household contacts and patients receiving chloramphenicol received rifampicin 20 mg/kg daily for four days. Index patients randomised to ceftriaxone were not treated with rifampicin. There was no significant difference in outcome between the two groups with respect to the mean duration of fever, the duration of intubation, or the length of hospital admission. The proportion of patients colonised with H influenzae type b four weeks after discharge was not significantly different between the two groups: ceftriaxone 5/22 (23%) versus chloramphenicol and rifampicin 3/23 (13%). A short course of ceftriaxone was successful in treating all patients with no significant side effects and no relapses. A short course of ceftriaxone is a safe, efficacious, and economic alternative to the standard treatment in children with epiglottitis.

Ceftriaxone↗
PubMedDate not supplied

Acute epiglottitis in adults. A review of 48 cases.

Acute epiglottitis was diagnosed infrequently in adults until the late 1960s and early 1970s. Because it is relatively rare, it may present a problem to the physician who sees an adult with sore throat and dysphagia, but does not think of epiglottitis. In this paper, we report our experience with 48 cases of acute epiglottitis in adults between the years 1963 and 1987. A discussion of the diagnosis and treatment of adult epiglottitis is presented. An adult with acute painful dysphagia should be considered to have epiglottitis until the diagnosis is proven otherwise.

Acute Disease↗
PubMed1987

Candida epiglottitis in immunocompromised patients.

Candida seldom has been reported to be a cause of epiglottitis. The clinical manifestations and management of three patients with Candida epiglottitis complicating their neoplastic disease are described. All patients were granulocytopenic. Candida epiglottitis occurred either as a localized infection, as a source of Candida bronchopneumonia, or as a manifestation of disseminated infection. Candida epiglottitis may be under-diagnosed and should be considered, especially in immunocompromised patients with symptoms of refractory pharyngitis. Treatment of Candida epiglottitis with intravenous amphotericin B is warranted in patients with sustained granulocytopenia. Prompt endotracheal intubation is indicated if the airway patency cannot be maintained.

Adult↗
PubMed2003

Paediatric acute epiglottitis re-visited.

INTRODUCTION: Paediatric acute epiglottitis is rare in Asia. The National University Hospital in Singapore has seen only two cases of paediatric acute epiglottitis in the last 10 years. The topic is re-visited here to remind physicians of its acutely dramatic progression. CLINICAL PICTURE: Both boys presented with a viral prodrome which progressed within hours to life-threatening upper airway obstruction. Examination revealed an inflamed epiglottitis. TREATMENT: They were successfully intubated and treated with intravenous antibiotics. OUTCOME: Both recovered uneventfully. CONCLUSION: Paediatric acute epiglottitis has declined markedly in the West with widespread vaccination against HiB. In contrast, the incidence of invasive HiB disease in Asia has always been low despite limited vaccination. Clinicians must remain vigilant of the possibility of acute epiglottitis in a child with "flu".

Acute Disease↗
PubMed1995

Epiglottitis and Haemophilus influenzae immunization: the Pittsburgh experience--a five-year review.

OBJECTIVE: Current trends in the clinical presentation and management of children with epiglottitis at Children's Hospital of Pittsburgh were reviewed for the years 1988 to 1993. METHODOLOGY: The medical records of all patients diagnosed as having epiglottitis between July 1988 and June 1993 at the Children's Hospital of Pittsburgh were reviewed. An additional telephone survey was conducted among the primary care physicians of those patients to collect information regarding administration of Haemophilus influenzae type b (HIB) vaccines. RESULTS: During the study period 28 children (age range, 11 months to 11 years, 10 months) were admitted with the diagnosis of epiglottitis. Cases declined remarkably in 1991. Fever, sore throat, and stridor were the usual symptoms. HIB was the most common cause of epiglottitis accounting for 21 cases. Candida albicans was recovered from the surface culture of the epiglottis in two patients. At least 11 children experienced vaccine failure: nine with polysaccharide vaccine and two with the conjugate vaccine for HIB. CONCLUSION: Cases of epiglottitis have declined dramatically since licensure of HIB conjugate vaccines for use in early infancy. At least 52% of the reported cases represent vaccine failures with the purified polysaccharide vaccine.

Bacterial Capsules↗
PubMed1998

The changing face of epiglottitis in Canterbury 1970-1996.

AIM: To record changes in the epidemiology, clinical presentation and management of the potentially fatal childhood disease, epiglottitis. METHODS: The case records of 69 children presenting to Christchurch Hospital with acute epiglottitis over the last 27 years were reviewed to confirm the diagnosis and to record clinical data. RESULTS: The incidence of epiglottitis increased significantly up until 1992. Since then there have been only two cases. This decline coincides with the availability of the Haemophilus influenzae Group b vaccine from 1993. Haemophilus influenzae was cultured in 86% of children. With the emergence of ampicillin resistant strains, antimicrobial therapy has changed to cephalosporins. Changes in airway management have also occurred, with the replacement of tracheostomy by elective naso-tracheal intubation. CONCLUSIONS: The incidence of epiglottitis in New Zealand has followed trends reported overseas. The longer term implications of this declining incidence following introduction of vaccination are not known. It is important however, that doctors still know how to recognize and manage acute epiglottitis in children and adults.

Acute Disease↗
PubMed1992

The relationship of vallecular residue to oral involvement, reduced hyoid elevation, and epiglottic function.

The purpose of this investigation was to identify certain variables that may result in vallecular residue after swallowing. The relationship between vallecular residue and oral-stage dysphagia, reduced hyoid elevation, and movement of the epiglottis was assessed in 330 patients referred to the speech pathology section for evaluation of oropharyngeal swallowing function. Patients with vallecular residue were more likely to have oral involvement or deviant epiglottic function, characterized by an absence of epiglottic inversion or incomplete inversion, than patients without vallecular residue. Although the primary focus of the study was between vallecular residue and the other select variables, the interrelationships among the three other variables were also studied. Patients with deviant epiglottic function were more likely to have oral involvement, reduced hyoid elevation, or vallecular residue than patients without deviant epiglottic function and patients with reduced hyoid elevation were more likely to have oral involvement than those with normal hyoid elevation. Multivariate analysis revealed that the relationship between oral involvement and deviant epiglottic function, present in the bivariate analysis, was not significant when controlling for other relationships in the model. The relationship between primary medical diagnostic category and the presence/absence of vallecular residue as well as the other dichotomous variables varied between and within diagnostic categories.

Adult↗