\s=b\Acute infectious uvulitis is a rare condition. A case caused by Streptococcus pneumoniae occurred in a 56-year-old woman who also had coexisting epiglottitis. One other case of uvulitis reported in the literature has also been associated with acute epiglottitis. Because of potentially lethal complications, epiglottitis should be suspected in any patient who presents with acute painful swelling of the uvula. (Arch Otolaryngol Head Neck Surg 1986;112:448-449) Acute painful swelling of the uvula -t\. is a rare infectious condition. Although edema of the uvula may be seen in various allergic or infectious conditions, frank uvulitis with mas¬ sive painful inflammation has rarely been reported. The association of uvu¬ litis with acute epiglottitis was first described by Rapkin1 in a 5-year-old girl infected with Haernophilus influ¬ enzae. We report herein a case of severe uvulitis and epiglottitis due to pneumococcus in an adult female patient.
REPORT OF A CASEA 68-year-old woman in previously good health except for mild controlled hyperten¬ sion and hyperuricemia developed acute onset of pain in the throat and experienced painful swallowing. Over the subsequent Reprint requests to 1145 S Utica, Tulsa, OK 74104 (Dr Westerman). eight hours she developed chills and fever, and she presented herself to the emergency room of St John Medical Center, Tulsa, Okla, where she began having difficulty breathing through the mouth.On examination, the patient appeared to be in moderate respiratory distress. Her temperature was 38°C. The uvula and soft palate were markedly swollen and hemor¬ rhagic and completely blocked the oral airway. Retraction of the uvula caused extreme pain, but visualization of the pos¬ terior pharynx revealed minimal erythema without exúdate. There was continuous drooling. The teeth and gums were unre¬ markable, and the floor of the mouth was not swollen. There was marked swelling of the neck at the left angle of the jaw with swelling and tenderness in the parotid space. The lungs were clear and abdominal examination findings were normal. The white blood cell admission count was 17,300/cu mm with a left shift.A nasopharyngeal airway was inserted and the patient's respiratory distress resolved. A lateral roentgenogram of the neck showed moderate enlargement of the epiglottis as well as edema of the uvula (Fig 1). A chest roentgenogram was nor¬ mal. Streptococcus pneumoniae grew from blood cultures and culture of the uvula.Chloramphenicol succinate and dexa¬ methasone were administered intrave¬ nously. Because the respiratory distress had resolved with the insertion of the nasopharyngeal airway, it was elected not to intubate the patient but to observe her closely in the intensive care unit. Racemic epinephrine was administered through a mist mask. Within six hours the uvular swelling had improved and the patient was able to breath without the nasopharyngeal airway.Over the next 48 hours progressive improvement occurred, with resolution of the uvular inflammation, decreased swell¬ ing of the lateral pa...
The propagation of sound in ice-covered waters, as in Canadian Arctic archipelago, is complicated by the sound's repeated encounters with the under surface of the ice. The essential elements of such a propagation environment were modeled, in air, in an anechoic chamber. The study concentrated on the effects of source motion, in the presence of various reflecting surfaces, on the coherence of sound received at a pair of sensors. The electrical signals from the sensors were processed in real time by a typical dual-channel spectrum analyzer. The study shows that when the sound reaches the sensors by reflection from an irregular solid surface, the degradation may be attributed to changes in the Doppler shifted components of the sounds at the sensors and to changes in acoustic interference patterns.
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