Acute Epiglottitis in Adults

Abstract

Most adults who have acute epiglottitis can be managed conservatively and have low morbidity and mortality.

Infectious and Noninfectious Causes of Epiglottitis in Adults, Review of 24 Patients

“…Unlike the case of the pediatric age group, the causative microbiological agent in adults is not easily identified, and the seasonal differences in the incidence of infection in adults are not as pronounced as they are in children (11). In our study, bacterial cultures were only taken from five patients, and one patient showed S. pneumoniae growth.…”

“…Although it is common in children between the age of 2 and 5 years, it can also be seen in adults. In adults, it is common in males between the age of 30 and 70 years (11). Epidemiological studies have shown that the number of acute epiglottitis cases has decreased in children due to proper vaccinations, while the number of adult cases has increased significantly (11,12).…”

Pseudomembranous supraglottitis with airway compromise in a patient with recurrent tonsillar carcinoma

“…Controversy persists concerning airway management of previously healthy adults with epiglottitis. 6 Some investigators have recommended that most patients with mild to moderate signs and symptoms of airway compromise may be managed conservatively with careful monitoring, 5,15,16 while others have argued that elective endotracheal intubation is a safer approach 8,17 based on a variety of clinical predictors. 5,[17][18][19] Despite this relative debate, it is intuitively obvious that immediate airway intervention is required for adults with acute epiglottitis and impending airway obstruction, including our patient.…”

“…21,22 Most commonly, blood cultures remain negative in patients with adult epiglottitis, 5,8,12 and cultures obtained directly from the epiglottitis and surrounding tissue during laryngoscopy also fail to identify the responsible bacterial pathogen. 7 As a result of these data, blood, epiglottic, and oropharyngeal cultures were not obtained in our patient and instead, empiric treatment with a broad-spectrum intravenous antibiotic (piperacillin-tazobactam) was instituted in order to provide coverage against H. influenzae, Streptococcus species, and Corynebacterium diphtheriae.…”

“…5 The microbiology of adult supraglottitis is also quite different from pediatric epiglottitis because H. influenzae is not the bacterial pathogen responsible for the vast majority of adult cases. 5,8 Most cases of adult epiglottitis occur in previous healthy adults, 3,5,[8][9][10][11][12] although hypertension, diabetes mellitus, immunosuppression, and the presence of an active substance abuse disorder have also been identified as predisposing risk factors. 5,9,13 In this report, we discuss a patient with acute pseudomembranous supraglottitis complicating recurrent tonsillar carcinoma and describe the ramifications of these disorders on perioperative management.…”