Routine computerised tomography in patients with acute supraglottitis for the diagnosis of epiglottic abscess: is it necessary? – a prospective, multicentre study

Lee, Y.C.; Kim, T.H.; Eun, Young Gyu

doi:10.1111/coa.12103

Cited by 19 publications

(24 citation statements)

References 21 publications

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“…In our study, around 20% of patients required surgery for abscess drainage whereas half of the CT scans disclosed signs of collected infection. This rate is higher than previously published [ 1 , 26 ]. Due to an unpredictable disease progression and unstable respiratory function, unanswered questions remain regarding the timing of imaging studies and management of abscesses.…”

Section: Discussioncontrasting

confidence: 73%

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Long-Term Outcome of Critically Ill Adult Patients with Acute Epiglottitis

et al. 2015

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BackgroundAcute epiglottitis is a potentially life threatening disease, with a growing incidence in the adult population. Its long-term outcome after Intensive Care Unit (ICU) hospitalization has rarely been studied.Methodology and Principal FindingsThirty-four adult patients admitted for acute epiglottitis were included in this retrospective multicentric study. The mean age was 44±12 years (sex ratio: 5.8). Sixteen patients (47%) had a history of smoking while 8 (24%) had no previous medical history. The average time of disease progression before ICU was 2.6±3.6 days. The main reasons for hospitalization were continuous monitoring (17 cases, 50%) and acute respiratory distress (10 cases, 29%). Microbiological documentation could be made in 9 cases (26%), with Streptococcus spp. present in 7 cases (21%). Organ failure at ICU admission occurred in 8 cases (24%). Thirteen patients (38%) required respiratory assistance during ICU stay; 9 (26%) required surgery. Two patients (6%) died following hypoxemic cardiac arrest. Five patients (15%) had sequelae at 1 year. Patients requiring respiratory assistance had a longer duration of symptoms and more frequent anti inflammatory use before ICU admission and sequelae at 1 year (p<0.05 versus non-ventilated patients). After logistic regression analysis, only exposure to anti-inflammatory drugs before admission was independently associated with airway intervention (OR, 4.96; 95% CI, 1.06-23.16).Conclusions and SignificanceThe profile of the cases consisted of young smoking men with little comorbidity. Streptococcus spp. infection represented the main etiology. Outcome was favorable if early respiratory tract protection could be performed in good conditions. Morbidity and sequelae were greater in patients requiring airway intervention.

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Section: Discussioncontrasting

confidence: 73%

“…CT scan has already been described as an important step in the management of these patients [ 26 ]. It can be performed after intubation or after favorable evolution of respiratory signs.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Critically Ill Adult Patients with Acute Epiglottitis

et al. 2015

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“…In their study, patients with epiglottic cysts were more prone to AWI and recurrent AS episodes. The use of computed tomography (CT)/magnetic resonance imaging (MRI) in AS has previously been advocated for the diagnosis of an epiglottic abscess . We suggest CT/MRI imaging is also indicated for patients with recurrent AS episodes in search of an anatomical underlying cause.…”

Section: Discussionmentioning

confidence: 99%

Adult acute supraglottitis: Analysis of 358 patients for predictors of airway intervention

et al. 2017

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“…Although EA has generally been thought to be an uncommon complication of acute epiglottitis, occurring in up to 4% of cases, several recent studies have reported a higher rate. [2][3][4] Berger et al 5 suggested that the rise in the incidence of EA could be due to misuse of antibiotics, leading to the emergence and spread of antimicrobial resistance. However, some authors have suggested that EA could be more frequently identified if patients are diagnosed using radiological technology, such as computed tomography (CT) scan.…”

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confidence: 99%