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Affiliation(s)
| | - Elliot Melendez
- Pediatric Critical Care, Johns Hopkins All Children's Hospital, St Petersburg, Florida
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2
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Abo Zaid S, Shoher S, Elovits M, Nasser W, Zamir G, Abo Zaid W, On A. Heamophilus Influenza-B Epiglottitis in a Vaccinated Child: A Note of Caution. Isr Med Assoc J 2018; 20:786-787. [PMID: 30550013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Said Abo Zaid
- Department of Pediatrics, Padeh Poria Medical Center, Tiberias, Israel
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Shira Shoher
- Department of Pediatrics, Padeh Poria Medical Center, Tiberias, Israel
| | - Merav Elovits
- Department of Pediatrics, Padeh Poria Medical Center, Tiberias, Israel
| | - Wael Nasser
- Department of Pediatrics, Padeh Poria Medical Center, Tiberias, Israel
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Goor Zamir
- Pediatric Intensive Care Unit, Emek Medical Center, Afula, Israel
| | - Wisam Abo Zaid
- Department of Pediatrics A, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel
| | - Avi On
- Department of Pediatrics, Padeh Poria Medical Center, Tiberias, Israel
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
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de Vries CJH, de Jongh E, Zwart S, van den Akker EHJ, Opstelten W. [Epiglottitis in adults in general practice: difficult to recognise and life-threatening]. Ned Tijdschr Geneeskd 2015; 159:A9061. [PMID: 26332815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Epiglottitis is a rare and life-threatening cause of acute sore throat. Usually, epiglottitis is caused by a bacterium, such as Haemophilus influenzae type b. Symptoms of epiglottitis are acute and rapidly progressive sore throat, a hoarse voice, fever, and drooling. We present two adult patients with acute sore throat who were diagnosed with epiglottitis. In adults with symptoms compatible with epiglottitis, it is justified to look down the throat with a light. Only if the view is impeded should a spatula be used but carefully. If there is a discrepancy between the severity of symptoms and few or no abnormal findings on examination of the throat, epiglottitis should be considered. If epiglottitis is suspected, referral to an ENT specialist is always indicated. Symptoms of upper airway obstruction, such as drooling, dyspnoea, inspiratory stridor and fear or anxiety, are an indication for emergency referral by ambulance.
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Affiliation(s)
- Corlien J H de Vries
- Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht
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Juul ML, Johansen HK, Homøe P. [Epiglottitis with an abscess caused by Haemophilus parainfluenzae]. Ugeskr Laeger 2014; 176:V11130683. [PMID: 25350891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A healthy 23-year-old man was admitted under the diagnosis of acute epiglottitis. Flexible fiber laryngoscopic examination showed a swollen epiglottis with an abscess. Microbiologic swab showed Haemophilus parainfluenzae, non-haemolytic Streptococcus and non-haemolytic Streptococcus salivarius. Only in 1984 a case of acute epiglottitis due to H. parainfluenzae has been described in the literature. Still, in this case we think that H. parainfluenzae was the most likely pathogen causing the abscess.
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Pöyhönen M, Bizaki A, Rautiainen M. [Supraglottitis in adults at a single center experience 1989-2009]. Duodecim 2013; 129:1598-1603. [PMID: 24163979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Acute epiglottitis in children has almost vanished since the start of Hib vaccinations. Supraglottitis often develops in adults more slowly than in children. We reviewed all patients at Tampere University Hospital over the age of 18, who had been recorded with a diagnosis of epiglottitis or supraglottitis upon discharge from the hospital between 1989 and 2009. The most common symptoms were sore throat and pain on swallowing. Streptococcus was the most common causative agent. Most of the 308 patients had received conservative treatment. Supraglottitis should be remembered as possible diagnosis when an adult person complains of a sore throat.
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Affiliation(s)
- Miia Pöyhönen
- TAYS, Tampereen yliopisto, korva-, nenä- ja kurkkutaudit
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Ge R, Mao Y, Zhang XL, Zheng SQ. Cervical necrotizing fasciitis and a descending mediastinal abscess caused by acute epiglottitis with diabetes mellitus: a life-threatening complication. Diabetes Res Clin Pract 2012; 95:e31-3. [PMID: 22088790 DOI: 10.1016/j.diabres.2011.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 10/02/2011] [Accepted: 10/10/2011] [Indexed: 11/26/2022]
Abstract
Cervical necrotizing fasciitis and a descending mediastinal abscess of the neck following acute epiglottitis, life-threatening complications, is reported in a 43-year-old man with DM. The bacterial culture showed Peptostreptococcus anaerobius. The patient recovered after surgical debridement and broad-spectrum antibiotics therapy.
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Affiliation(s)
- Rongming Ge
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Tongji Hospital, Tongji University Medical School, Shanghai 200065, China.
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Hirshoren N, Eliashar R, Weinberger JM. Candida epiglottitis: a rare emergent condition--appearance, treatment and pitfalls. Eur J Intern Med 2008; 19:e84-5. [PMID: 19046711 DOI: 10.1016/j.ejim.2008.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 03/17/2008] [Accepted: 04/25/2008] [Indexed: 11/27/2022]
Affiliation(s)
- Nir Hirshoren
- Department of Otolaryngology/Head & Neck Surgery, Hadassah Ein-Kerem University Hospital, Jerusalem, 91120, Israel.
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Mathoera RB, Wever PC, van Dorsten FRC, Balter SGT, de Jager CPC. Epiglottitis in the adult patient. Neth J Med 2008; 66:373-377. [PMID: 18931398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Epiglottitis is an acute disease, which was predominantly caused by Haemophilus influenzae type b in the pre-vaccination era. In the vaccination era, with waning vigilance, adults remain at risk for acute epiglottitis according to recent Dutch incidence rates. There is more diversity in the cause of epiglottitis in adults. We describe three patients who presented to the emergency ward of a regional teaching hospital with severe epiglottitis. All three patients had stridor at presentation indicating a compromised airway. Emergency intubation was attempted, but two patients required a tracheotomy and one patient died. Patients received fibreoptic nasal intubation, systemic dexamethasone and antibiotics. Stridor is an important acute sign of upper airway obstruction, which requires vigilance for epiglottitis, regardless of the patient's age. Fibreoptic nasal intubation should preferentially be attempted with the possibility of immediate surgical airway on hand. Timely diagnosis and treatment usually results in a complete recovery. In adults, severe acute epiglottitis and stridor can justify early intubation.
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Affiliation(s)
- R B Mathoera
- Department of Intensive Care Medicine, 's-Hertogenbosch, the Netherlands
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Abstract
Bacterial superinfection complicating varicella is not uncommon, but airway complications are rare. We report a case of varicella in a 2-year-old boy complicated by life-threatening stridor secondary to group A streptococcal epiglottitis.
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Isakson M, Hugosson S. [Acute epiglottitis now affecting adults is mostly caused by pneumococci. Important to observe the incidence when considering future vaccination strategy]. Lakartidningen 2007; 104:3531-3533. [PMID: 18203585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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12
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Mimouni O, Nicollas R, Roman S, Triglia JM. [Acute laryngitis and epiglottitis in children]. Rev Prat 2007; 57:1796-1800. [PMID: 18092723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The anatomical characteristic of the pediatric larynx allows physicians to better understand the incidence of symptomatic and severe presentations of acute laryngitis, which are frequent pediatric emergencies. Subglottis laryngitis and epiglottitis must be distinguished from each other. These two diseases are absolutely different: the first one is essentially viral and usually moderate, even though acute respiratory distress can occur. The other (epiglottitis) is bacterial, essentially caused by Haemophilus influenza B (Hi-B), and can be life threatening. The anti Hi-B vaccine leads to a decrease of frequency but does not make them disappear. Moreover, even if a child has a history of the Hi-B vaccine, diagnosis of epiglottitis can not to be ruled out. Lastly, in case of acute laryngeal dyspnea in a child, one must think about a foreign body.
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Affiliation(s)
- Olivia Mimouni
- Service d'oto-rhino-laryngologie pédiatrique et chirurgie cervico-faciale, hôpital d'enfants de La Timone, 13385 Marseille
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Abstract
Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these illnesses are both benign and self-limited. The most important bacterial cause is the beta-hemolytic group A streptococcus. There are other uncommon or rare types of pharyngitis. For some of these treatment is required or available, and some may be life threatening. Among those discussed in this article are diphtheria, gonorrhea, HIV infection, peritonsillar abscess, and epiglottitis.
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Affiliation(s)
- Maria L. Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1400 NW 10th Avenue, 090-A Dominion Tower #812, Miami, FL 33136, USA
- Medical Service, Infectious Diseases Section (111-1), Miami Veterans Affairs Healthcare System, 1201 NW 16th St., Miami, FL 33125, USA
| | - Alan L. Bisno
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1400 NW 10th Avenue, 090-A Dominion Tower #812, Miami, FL 33136, USA
- Medical Service (111), Miami Veterans Affairs Healthcare System, 1201 NW 16th St., Miami, FL 33125, USA
- Corresponding author. Medical Service (111), Miami Veterans Affairs Healthcare System, 1201 NW 16th St., Miami, FL 33125.
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Chiou CC, Seibel NL, Derito FA, Bulas D, Walsh TJ, Groll AH. Concomitant Candida epiglottitis and disseminated Varicella zoster virus infection associated with acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2006; 28:757-9. [PMID: 17114965 DOI: 10.1097/01.mph.0000243654.18314.c1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acute epiglottitis by nonbacterial pathogens is an uncommon but life-threatening clinical entity. Herein, we report the concomitant occurrence of Candida epiglottitis and mucosal and visceral Varicella zoster virus infection in a child with acute lymphoblastic leukemia. Both infections were atypical in their presentation, occurred in a severely immunocompromised host, and required invasive procedures for diagnosis.
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Affiliation(s)
- Christine C Chiou
- Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA
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Affiliation(s)
- Ellen M Chiocca
- Niehiff School of Nursing, Loyola University, Chicago, IL, USA
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Acute epiglottitis. Nurs Times 2006; 102:31. [PMID: 16605147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Yousuf K, Lui B, Lemckert R, Sommer D. Recurrent adult epiglottitis: contiguous spread from group A streptococcus lingual tonsillitis. J Otolaryngol 2006; 35:65-7. [PMID: 16527021 DOI: 10.2310/7070.2005.4119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- Kashif Yousuf
- Department of Otolaryngology, McMaster University, Hamilton, ON
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Caballero M, Sabater F, Traserra J, Alòs L, Bernal-Sprekelsen M. Epiglottitis and necrotizing fasciitis: a life-threatening complication of infectious mononucleosis. Acta Otolaryngol 2005; 125:1130-3. [PMID: 16298800 DOI: 10.1080/00016480510027475] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Life-threatening cervical complications associated with infectious mononucleosis are rare. The combination of acute epiglottitis and subsequent necrotizing fasciitis of the head and neck in a patient with infectious mononucleosis has not been reported to date.A 47-year-old female with infectious mononucleosis and epiglottitis was admitted to hospital for i.v. therapy. Owing to her poor clinical condition and the spread of the infection to the throat and superior mediastinum, as evidenced by CT, a cervical debridement was performed. After cervical debridement, histological findings were consistent with necrotizing fasciitis. The bacteria identified were Streptococcus viridans, Veilonella spp. and Capnocytophaga spp. The patient was hospitalized for 33 days.Mononucleosis, usually a benign condition, may be associated with life-threatening septic complications in the neck and chest. Serial CT or MRI scans are necessary to assess the development of the infection in the deep layers of the neck. Rapid medical treatment, extensive surgical debridement and intensive care are vital.
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Affiliation(s)
- Miguel Caballero
- Department of Otorhinolaryngology, Hospital Clínic and University of Barcelona, Barcelona, Spain.
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Affiliation(s)
- Ricardo Negroni
- Hospital de Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
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Zielnik-Jurkiewicz B. [The role of the bacterial inflammation in subglottic laryngitis in children]. Pol Merkur Lekarski 2005; 18:141-5. [PMID: 17877117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The aim of this study is to assess the impact of some selected bacteriological factors on the occurrence of subglottic laryngitis in children. The research covered 72 children hospitalized in the Children's Hospital in Warsaw with the following symptoms: dry barking cough, stridor, inspiratory dyspnoea with the participation of auxiliary respiratory muscles, agitation and change of colour of skin. Subglottic laryngitis is one of the acute children's diseases, directly caused by a violently growing odema of the subglottic area. The disease constitutes 5-8% of all severe airways inflammations and states that subglottic laryngitis is responsible for 6.5% off all lower airways inflammation cases. Based on preliminary examinations, the patients were divided into two groups--one of them composed of 41 patients with simultaneous atopy, the other--of 31 patients with no atopy symptoms. The examination of each patient included subjective, objective (pediatric and laryngological) and auxiliary (primary-blood cell count, OB and specialized-bacteriological tests) examinations. Own research showed that out of 72 patients with subglottic laryngitis 56.95% had bacterial symptoms. 90.32% in non atopic group have higher NBT test, in atopic children it was 39.02%. We observed that 50.51% of the patients suffering from subglottic laryngitis had an inflammation of upper airways (otitis media, rhinitis, pharyngitis) and 13.89% of lower respiratory tract (bronchitis, pneumonitis). Many authors incline to say that bacteria may be a conductive factor for subglottic laryngitis to develop. However, many factors seem to suggest that the occurrence and symptoms of subglottic laryngitis are primarily caused by the reaction to an infection. The impact of bacteria onto the etiopathogenesis of subglottic laryngitis has been discussed for many years. Some experts are of the opinion that the disease develops on the bacteriologic background.
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Abstract
We report a case of an adolescent with human immunodeficiency virus infection who presented with epiglottitis caused by Candida albicans. This patient's symptom was severe oropharyngeal thrush without the classic manifestations of epiglottitis. Atypical organisms can cause epiglottitis in immunocompromised adolescents and they can have mild symptoms.
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Affiliation(s)
- Niraj Sharma
- University of Miami School of Medicine, Miami, FL, USA
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Bruun B, Gahrn-Hansen B, Westh H, Kilian M. Clonal relationship of recent invasive Haemophilus influenzae serotype f isolates from Denmark and the United States. J Med Microbiol 2004; 53:1161-1165. [PMID: 15496397 DOI: 10.1099/jmm.0.45749-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Surveillance performed after the introduction of general Haemophilus influenzae serotype b (Hib) vaccination in Denmark identified 13 cases of invasive bacteraemic H. influenzae serotype f (Hif) disease in adults over a period of 7 years. Bacteraemic respiratory tract infections accounted for 61 % of cases, but meningitis, epiglottitis and osteoarthritis were also seen. Recent Danish isolates were compared to recent American isolates, historical Hif strains and non-Hif invasive strains. Results of conventional serotyping were confirmed by PCR detection of the serotype-f-specific cap and bexA gene sequences. Multilocus enzyme electrophoresis typing revealed that recent Danish and American isolates belonged to a single Hif clone, which may be undergoing expansion. The need for accurate serotyping of H. influenzae to enable reliable monitoring for Hib replacement by other capsular types is emphasized.
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Affiliation(s)
- Brita Bruun
- Department of Clinical Microbiology, Statens Serum Institut, Artillerivej 5, DK 2300 Copenhagen S, Denmark 2Department of Clinical Microbiology, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød, Denmark 3Department of Clinical Microbiology, Odense University Hospital, J. B. Winsløvsvej 21.2, DK 5000 Odense C, Denmark 4Department of Clinical Microbiology, Hvidovre Hospital, Kettegaard Alle 30, DK 2650 Hvidovre, Denmark 5Department of Medical Microbiology and Immunology, Århus University, Universitetsparken, DK 8000 Århus C, Denmark
| | - Bente Gahrn-Hansen
- Department of Clinical Microbiology, Statens Serum Institut, Artillerivej 5, DK 2300 Copenhagen S, Denmark 2Department of Clinical Microbiology, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød, Denmark 3Department of Clinical Microbiology, Odense University Hospital, J. B. Winsløvsvej 21.2, DK 5000 Odense C, Denmark 4Department of Clinical Microbiology, Hvidovre Hospital, Kettegaard Alle 30, DK 2650 Hvidovre, Denmark 5Department of Medical Microbiology and Immunology, Århus University, Universitetsparken, DK 8000 Århus C, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Statens Serum Institut, Artillerivej 5, DK 2300 Copenhagen S, Denmark 2Department of Clinical Microbiology, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød, Denmark 3Department of Clinical Microbiology, Odense University Hospital, J. B. Winsløvsvej 21.2, DK 5000 Odense C, Denmark 4Department of Clinical Microbiology, Hvidovre Hospital, Kettegaard Alle 30, DK 2650 Hvidovre, Denmark 5Department of Medical Microbiology and Immunology, Århus University, Universitetsparken, DK 8000 Århus C, Denmark
| | - Mogens Kilian
- Department of Clinical Microbiology, Statens Serum Institut, Artillerivej 5, DK 2300 Copenhagen S, Denmark 2Department of Clinical Microbiology, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød, Denmark 3Department of Clinical Microbiology, Odense University Hospital, J. B. Winsløvsvej 21.2, DK 5000 Odense C, Denmark 4Department of Clinical Microbiology, Hvidovre Hospital, Kettegaard Alle 30, DK 2650 Hvidovre, Denmark 5Department of Medical Microbiology and Immunology, Århus University, Universitetsparken, DK 8000 Århus C, Denmark
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Abstract
OBJECTIVE To describe the epidemiology, natural history, and treatment of epiglottitis in the Hemophilus influenzae type B (Hib) vaccine era. DESIGN Ten-year retrospective study. SETTING Tertiary-care children's hospital. PATIENTS Nineteen patients with a discharge diagnosis of epiglottitis. INTERVENTION As indicated by the presentation of the patient, including direct laryngoscopy, intubation, intravenous antibiotics, and steroids. MAIN OUTCOME MEASURES Presentation, management, and microbiology. RESULTS Presenting symptoms included fever, drooling, and hot potato voice. Patients' ages ranged from 15.8 months to 17.5 (mean 8.9) years. From 1992 to 1997, the mean age was 5.8 years; from 1998 to 2002, the mean age was 11.6 years. Sixty-eight percent of patients were transferred from an outside hospital. A lateral neck radiograph was recorded in 84% of patients. Mean leukocyte count was 16600. Direct laryngoscopy with intubation was performed in 79%; intubation was for an average of 3.5 days. H. influenzae was cultured in six patients, five of which had up-to-date immunizations. The most commonly administered antibiotics were ampicillin/sulbactam and ceftriaxone. Steroids were administered to 63% of patients. Complications included deep neck space infection (2), seizure (1), recurrent illness (1), and vocal granuloma (1). There were no deaths. CONCLUSION The demographics, causative organisms, and natural history of epiglottitis have changed substantially in the Hib vaccination era. The clinician evaluating and treating patients with epiglottitis should be aware of current trends.
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Affiliation(s)
- Rahul K Shah
- Department of Otolaryngology-Head and Neck Surgery, Tufts-New England Medical Center, Boston, MA, USA
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Gilbert A, Downey TJ. Epiglottic abscess. Ear Nose Throat J 2004; 83:154-5. [PMID: 15086004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Affiliation(s)
- Andrew Gilbert
- Department of Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Wash, USA
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Mathur KK, Mortelliti AJ. Candida epiglottitis. Ear Nose Throat J 2004; 83:13. [PMID: 14986749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Affiliation(s)
- Kevin K Mathur
- Department of Otolaryngology-Head and Neck Surgery, State University of New York, Upstate Medical University, Syracuse, USA
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Zhukhovitskiĭ VG. [Effective antibacterial therapy in otorhinolaryngology: bacteriological rationale]. Vestn Otorinolaringol 2004:5-14. [PMID: 15029119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The article presents current views on etiopathogenesis of the diseases associated with contamination with microorganisms; reviews inflammatory ENT diseases in terms of current literature on clinical microbiology of these diseases; characterizes microorganisms more or less specific for each relevant nosological entity; analyses basic groups of antibacterial drugs with formulation of bacteriologically grounded principles of initial antibacterial therapy of ENT inflammation.
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Eliseev OV, Balandin AV, Dimova AD. [Management of ENT diseases complications using ticarcillin clavulanate]. Vestn Otorinolaringol 2004:51-2. [PMID: 15134082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Low YM, Leong JL, Tan HKK. Paediatric acute epiglottitis re-visited. Singapore Med J 2003; 44:539-41. [PMID: 15024460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
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".
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Affiliation(s)
- Y M Low
- Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore 169608.
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30
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Affiliation(s)
- Glenn Isaacson
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, First Floor Kresge, 3400 North Broad Street, Philadelphia, PA 19140, USA.
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Hanousek J, Swart M. Haemophilus influenzae type B (HiB) is back. Anaesthesia 2003; 58:813-4. [PMID: 12859491 DOI: 10.1046/j.1365-2044.2003.03295_16.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jiang JH, Chiu NC, Lin YY, Lee KS, Lee HC, Huang FY. Acute epiglottitis caused by Haemophilus influenzae type b: a case report. J Microbiol Immunol Infect 2003; 36:69-71. [PMID: 12741738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Acute epiglottitis is an inflammatory, edematous disease of the epiglottis and adjacent structures, usually caused by Haemophilus influenzae type b. It is a life-threatening condition, occurring mainly in childhood. There have never been any reports of this condition in Taiwan. We report a case of 4-year-old boy who presented with characteristics of systemic illness combined with respiratory distress on arrival at the emergency room. His mouth was open and his neck was hyperextended. The diagnosis of epiglottitis was established on the basis of physical examination, lateral neck x-ray, and the finding of an enlarged, swollen, erythematous epiglottis on flexible fiberoptic laryngoscopy. Urine latex agglutination test for H. influenzae type b was positive and a blood culture grew H. influenzae type b. He was treated with cefotaxime and did not require intubation.
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Affiliation(s)
- Jia-Horng Jiang
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, ROC
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Williams S. A sore throat in a dialysis patient. Anaesthesia 2003; 58:285. [PMID: 12603462 DOI: 10.1046/j.1365-2044.2003.30546.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- David Garner
- Department of Microbiology and Public Health Laboratory, Queens Medical Centre, University Hospital, NG7 2UH, Nottingham, UK.
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Wick F, Ballmer PE, Haller A. Acute epiglottis in adults. Swiss Med Wkly 2002; 132:541-7. [PMID: 12557859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
Acute epiglottitis can be a serious life-threatening disease because of its potential for sudden upper airway obstruction. It is a well-recognised entity in children but it is uncommon in adults and therefore is often misdiagnosed. In this retrospective study we present twelve cases of acute epiglottitis in adults. The diagnosis was made by visualisation of the epiglottis using fibreoptic laryngoscopy. The illness was managed using a standardised management protocol (see Appendix). The most frequent symptoms were odynophagia (100%), inability to swallow secretions (83%), sore throat (67%), dyspnoea (58%) and hoarseness (50%). Body temperature was elevated (>37.2 degrees C) in 75% and 50% of the patients had tachycardia (>100 bpm). The supposedly typical sign of stridor was found in only 42% of the cases. A routine oropharyngeal examination does not exclude epiglottitis, 44% of our patients had a normal oropharynx and the diagnosis could only be made following fibreoptic laryngoscopy. Nasotracheal intubation was necessary in four patients. A 40-year-old man with sore throat, hoarseness, cough and odynophagia was initially seen by a physician. With the suspected diagnosis of an infection - induced exacerbation of bronchial asthma, he was treated with antibiotics, paracetamol und corticosteroids. On admission six hours later the patient was in coma. The diagnosis was not made until conventional oral endotracheal intubation (without a tracheotomy set placed at the bedside) was attempted. Unfortunately the intubation failed and the patient died. Medical management of epiglottitis in adults includes an antibiotics, NSAIDs and possibly inhalation with adrenaline. The maintenance of an adequate open airway is the main concern in adults as well as in children. Although most adults have no signs of airway obstruction, the clinical threshold for insertion of an airway should remain low, as it is the only way of preventing death. A high index of suspicion is needed to recognise this rare disease correctly and patients must be admitted to a hospital with intensive care facilities, where the diagnosis can be confirmed and intubation performed if necessary and thus reduce the mortality rate.
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Abstract
Epiglottitis can be a rapidly fatal condition in adults. Important clues that should raise clinical suspicion include the tripod sign, fever, stridor, sore throat, odynophagia, shortness of breath, and drooling. These features must be differentiated from those associated with common viral infections. The most helpful diagnostic studies are radiography of the neck and direct laryngoscopy. The patient's airway should be monitored during evaluation to avoid obstruction. Successful management requires teamwork between the primary care physician and personnel skilled in intubation as well as timely consultation with an otolaryngologist. Laryngoscopy and intubation always should be performed by the most skilled personnel because repeated attempts may increase periepiglottal swelling and the risk of airway obstruction. Racemic epinephrine should be avoided because of the rebound effect. Awareness of the possibility of epiglottitis in adults and close monitoring of the airway are the keys to management of this potentially life-threatening condition.
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Affiliation(s)
- Jonathan L Sack
- Department of Family Medicine, Medical University of South Carolina College of Medicine, 9298 Medical Plaza Dr, Charleston, SC 29406, USA.
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Abstract
Respiratory illnesses are the leading reason for seeking medical care here in the United States. Streptococcus pneumoniae is the most common bacterial pathogen causing acute otitis media (AOM), sinusitis, and community-acquired pneumonia in both the pediatric and adult populations. The continued development of antibiotic resistance to an increasing number of different antibiotic classes by this organism has made the treatment of some of these infections more difficult. Recently, a heptavalent pneumococcal conjugate vaccine was approved for infants and toddlers, beginning at 2 months of age. Widespread implementation of this vaccine in the childhood population may have a significant impact on the amount of systemic disease seen with this organism.
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Affiliation(s)
- Tina Q Tan
- Department of Pediatrics, Northwestern University Medical School, Chicago, IL 60614, USA.
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Abstract
BACKGROUND To examine the common presentations and management of acute epiglottitis in adults. METHOD Retrospective clinical study of 17 consecutive adult patients who presented to the Royal Melbourne Hospital between January 1988 and December 2000 was undertaken. RESULTS The mean patient age was 47 years (range 20-87 years) and the male-to-female ratio was 1.8 : 1.0. Peak incidence occurred in September during early spring. All patients presented with sore throat and dysphagia; however, respiratory distress was only noted in 65%. The most common signs were temperature and tachycardia. Four patients (23%) required endotracheal intubation, which was performed electively in three and as an emergency in one. Three of 14 blood cultures were positive, two yielded Haemophilus influenzae type b and one yielded Streptococcus mitis. One of the four throat cultures was positive for Haemophilus influenzae type b. Twelve patients underwent awake flexible laryngoscopy under topical anaesthetic as part of their initial assessment, and there were no complications associated with this procedure. There was no mortality. CONCLUSIONS The diagnosis of acute epiglottitis in the adult population is difficult as respiratory distress may be absent. Patients who have a significant sore throat with no obvious aetiology should have direct visualization of their larynx by flexible laryngoscopy. Lateral X-ray of neck is of limited value. Once diagnosed, these patients should be hospitalized and monitored as airway obstruction may develop rapidly.
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Affiliation(s)
- E Y Wong
- Royal Melbourne Hospital, Parkville, Victoria, Australia
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Abstract
The incidence of acute epiglottitis in children has declined with the introduction of the Haemophilus influenzae b vaccine in 1992. We report a case of acute epiglottitis in a child secondary to an immunocompromised state. We suggest that when acute epiglottitis is diagnosed in a child we should ensure there is no underlying predisposing condition.
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Affiliation(s)
- H C Cocks
- Division of Medical Sciences, University of Birmingham, UK.
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Lee TW, Sandoe JA. Epiglottitis caused by group C streptococcus. Acta Paediatr 2001; 90:1085. [PMID: 11683204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Schüpbach J, Bachmann D, Hotz MA. [Epiglottitis--a pediatric disease?]. Schweiz Med Wochenschr 2001; Suppl 125:35S-37S. [PMID: 11141935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Epiglottitis, commonly described as a paediatric disease, also occurs in adults. Early diagnosis and immediate treatment are crucial because of the rapid and possibly lethal course of upper airway obstruction due to swelling. Initial treatment consists in securing the upper airway and in antibiotic treatment. Streptococci and, especially in children, Haemophilus influenzae b are the most common bacteria. Our study focused on clinical and epidemiological changes since children started to be vaccinated against Haemophilus influenzae b in Switzerland (1992). We reviewed patient histories of 31 adults and 88 children who were hospitalised with epiglottitis at the University Hospital of Berne between 1989 and 1999. Our findings show that the incidence of epiglottitis in children, a clinically, epidemiologically and bacteriologically homogeneous disease, has dramatically decreased. Epiglottitis in adults presents as a more heterogeneous disease without change since the beginning of the vaccination programme. Due to the variety of germs it is impossible to recommend vaccination for adults against Haemophilus influenzae b.
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Affiliation(s)
- J Schüpbach
- Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Hals-, Kiefer- und Gesichtschirurgie, Inselspital Bern
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Damborenea Tajada J, De Miguel García F, Naya Gálvez MJ, Campos del Alamo MA, Martínez Berganza R, Marín Garrido C, Ortiz García A. [Acute epiglottitis in the adult. Retrospective study of 14 cases]. An Otorrinolaringol Ibero Am 2000; 27:177-84. [PMID: 10829496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Acute epiglottitis instead of been a well recognised disease in children, is a rare condition in adult patients. Failure to diagnose epiglottitis early, in adults, undoubtedly contributes to its continuing mortality. We report our experience with acute epiglottitis in grown-up people with a retrospective series of 14 patients seen in our Department from 1993 to 1997. We comment about clinical features and therapeutic management of these patients.
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Abstract
Epiglottitis in adults is a dangerous infectious disease with a rising incidence and potential fatal complications as illustrated in this case report. Like in children, skilled and aggressive airway protection with appropriate antibiotic therapy have been effective in reducing mortality.
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Affiliation(s)
- S P Kuppens
- Department of Internal Medicine, Hospital Gooi-Noord, 1250 CA, Blaricum, The Netherlands
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Abstract
In view of the increased resistance to antibiotics in several upper airway pathogens, the clinical rationale for use of antimicrobial therapy in various upper respiratory tract infections is discussed. The diagnostic skill and the clinical significance of various bacteria are taken into account and strategies for treatment of the different infections, with focus on acute otitis media, are discussed.
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Affiliation(s)
- K Prellner
- Department of Otorhinolaryngology, University Hospital of Lund, Sweden
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Abstract
Varicella is a nearly ubiquitous acquired childhood disease. Infectious complications of varicella can be life- or limb-threatening. These complications appear 3 to 4 days after the appearance of varicella exanthem and are heralded by fever, pain, and erythema of the overlying skin. Airway complications of varicella are rare, rapidly evolving, and, unfortunately, difficult to visualize. We report a child who presented with a unique combination of varicella-induced airway complications-acute epiglottitis and subsequent necrotizing fasciitis of the head and neck. varicella, epiglottitis, necrotizing fasciitis, group A beta-hemolytic streptococcus, nasopharyngoscopy.
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Affiliation(s)
- C L Slack
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital, Denver, Colorado, USA.
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Berni Canani F, Mansi N, Natale A, De Vita C. [Acute epiglottitis in children: current criteria for the diagnosis and treatment]. Acta Otorhinolaryngol Ital 1999; 19:272-5. [PMID: 10827801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Acute epiglottitis is still a potentially lethal pathology, particularly in early childhood. The present study involves seven cases of acute epiglottitis in children under 4 years of age. The authors describe the diagnostic and therapeutic protocols used in these pediatric patients placing particular emphasis on the use of endoscopy and the need for prompt hospitalization in an intensive care unit to best integrate the diagnostic approach with therapeutic treatment.
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Affiliation(s)
- F Berni Canani
- U.O. di Otorinolaringoiatria e Patologia Cervico-Facciale, A. O. Santobono, Pausilipon, Napoli
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Midwinter KI, Hodgson D, Yardley M. Paediatric epiglottitis: the influence of the Haemophilus influenzae b vaccine, a ten-year review in the Sheffield region. Clin Otolaryngol Allied Sci 1999; 24:447-8. [PMID: 10542929 DOI: 10.1046/j.1365-2273.1999.00291.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cases of acute epiglottitis in children have become very uncommon in recent years. This study set out to find whether the introduction of the Haemophilus influenzae b (Hib) vaccine in the UK in October 1992 has influenced the incidence of acute epiglottitis in the Sheffield region, and whether the pathogenesis has altered. A 10-year retrospective case note review was undertaken. A total of 30 children were treated for acute epiglottitis in Sheffield Children's Hospital over that time period. A sharp decline in the number of cases was found after the vaccine was introduced. Most children presenting with the disease after October 1992 had not been vaccinated. In addition, the pathogens isolated in those children who had received the vaccine were all Streptococci. This is the first study in the UK to examine the influence of the Hib vaccine on acute paediatric epiglottitis.
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