Epiglottitis in the adult

Robbins, Jeffrey P.; Fitz‐Hugh, G. Slaughter

doi:10.1288/00005537-197105000-00009

Cited by 41 publications

(7 citation statements)

References 8 publications

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“…Discussion Seven of our patients were male and two were female. This male preponderance agreed with other series (Robbins and Fitz-Hugh, 1971;Morgenstein and Abramson, 1971;Hawkins et al, 1973;Bass, 1974). Age ranged from 26 to 74 years with maximum incidence in the fifth decade (Table I).…”

supporting

confidence: 91%

“…In recent years there have been more reports, and many authors have stressed the rapidity of its course and its high mortality rate in adults also. Up to 1971 there was a 50 per cent mortality rate in all reported cases (Morgenstein K. M. and Abramson A. L., 1971;Robbins J. P. and Fitz-Hugh, G. S. 1971). In Cardiff, we have seen nine cases in the past ten years.…”

mentioning

confidence: 83%

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Acute epiglottitis in adults

Kander

Richards

1977

J. Laryngol. Otol.

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supporting

confidence: 91%

mentioning

confidence: 83%

Acute epiglottitis in adults

Kander

Richards

1977

J. Laryngol. Otol.

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“…Considerable debate exists as to whether epiglottitis in adults is more or less severe than in children. Two series quote a mortality of 32-50 per cent (Morganstein and Abramson, 1971;Robbins and Fitz-Hugh, 1971). The larger adult glottis with a less loose mucosa than that in the child may make respiratory obstruction less likely.…”

Section: Discussionmentioning

confidence: 99%

Acute epiglottitis in adults not due to haemophilus

Russell¹,

Gresham²,

Wight³

1985

J. Laryngol. Otol.

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“…The early placement of an artificial airway in children has significantly reduced mortality. Moreover, since airway obstruction is the most common cause of death in adults in whom an airway is not secured when the diagnosis of supraglottitis is made [2], some authors favor establishing an artificial airway prophylactically as is done in children [2,5,34,35]. We and others tend to reserve intubation for those adult patients with early signs of airway obstruction [8,10,21,22,25,26,28,3Ca].…”

Section: Diagnosismentioning

confidence: 99%

Upper Respiratory Tract Infections in the Critically I11

Jacobs

Irwin

Raptopoulos

1990

J Intensive Care Med

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that present in the critically ill (supraglottitis [epiglottitis], deep neck infections, and sinusitis) is presented with attention to pathogenesis, pathophysiology, diagnosis, differential diagnosis, and treatment. Supraglottitis is increasingly diagnosed in adults and, as with children, early recognition is crucial to limit mortality. To aid in diagnosis and treatment, a management algorithm is used. Deep cervical infections, usually extensions of upper airway infections, can spread along fascial planes with fatal results. Knowledge of the interconnections between anatomical spaces is a prerequisite to diagnosis and treatment. Sinusitis will present in the critically ill as orbital or intracranial complications or as a nosocomial infection. Discussions of acute and chronic community-acquired sinusitis in general, nosocomial sinusitis, and sphenoid sinusitis as a separate entity highlight differences in clinical presentation and bacteriology that are important to diagnosis and treatment.The upper respiratory tract consists of the nose, mouth, nasopharynx and oropharynx, hypopharynx. and the paranasal sinuses. While minor infections in these areas are common outpatient entities, they may infrequently become severe and life threatening. It is this class of disease that requires intensive observation and aggressive treatment, and is the focus of this review. Supraglottitis (Epiglottitis). Acute supraglottitis is an uncommon infection of the epiglottis and other supralaryngeal structures, which may progress to abrupt and fatal airway obstruction. The condition is well recognized in children, in whom the presentation and course are usually fulminant. In pediatric age groups, increased awareness and prophylactic airway control have reduced the overall mortality to less than 1% [1]. In adults, however, the course is often more indolent and the mortality approximates 7%, largely due to misdiagnosis and unexpected airway obstruction [2]. Pathogenesis and Pathophysiology. Supraglottitis, the term more recently preferred, since it is more anatomically correct, is an acute, usually bacterial inflammation of the supraglottic structures including the epiglottis, aryepiglottic folds, and arytenoids. The true vocal cords are seldom involved in the process. Since the lingual aspect of the epiglottis in children has a more loose mucosa than in adults, providing an easy space for edema to collect [3], swelling in this area tends to curl the epiglottis posteriorly and inferiorly, accentuating the juvenile &dquo;omega&dquo; shape characteristically seen in children. This swelling reduces the airway aperture [4]. The obstruction increases and respiratory distress occurs when edema spreads and involves the aryepiglottic folds [5]. Inspiration draws these swollen structures downward, thus exacerbating the obstruction and producing stridor [6]. Since the larynx is larger and the epiglottis is shaped less like an omega and more like a &dquo;spatula&dquo; in adults [7], these

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Epiglottitis in the adult

Cited by 41 publications

References 8 publications

Acute epiglottitis in adults

Acute epiglottitis in adults

Acute epiglottitis in adults not due to haemophilus

Upper Respiratory Tract Infections in the Critically I11

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