Infectious and noninfectious epiglottitis in adults: our experience

Authors

  • Altaf Malik Department of Surgery, GMC Doda, Jammu and Kashmir, India
  • Rahil Muzaffar Department of Otorhinolaryngology, GMC Doda, Jammu and Kashmir, India
  • Sumat Ul Khurshid Department of Pathology, GMC Doda, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20230006

Keywords:

Epiglottitis, Stridor, Sore throat

Abstract

Background: The present prospective study was conducted in the department of ENT at GMC Doda for a period of three years from February 2019 to March 2022. The study aimed at evaluating the causes, presentation and management of adult epiglottitis.

Methods: The patients presenting with the sign and symptoms of epiglottitis were evaluated and were subjected to rigid/flexible endoscopic examination. Patients presenting with respiratory distress were categorized as per Freidman’s classification.

Results: Epiglottitis was seen in 21 patients with 13 male and 8 female patients. The age distribution was between 26 and 68 years (mean, 44.4±11.3). Infection, as a cause of epiglottitis was present in 14 subjects and 7 patients had non infectiousetiology. Corrosive ingestion (HCL) and angioedema was seen in two patients each. Hot water aspiration, hot milk and foreign body aspiration (fish bone) was present in the rest of three patients each. Most common complaint of patients in our study was sore throat followed by painful swallowing and voice change.

Conclusions: Epiglottitis in adults can be easily overlooked because of its non-specific presentation. Importance needs to be stressed upon the examination of larynx in patients presenting with sore throat not responding to conventional treatment or with symptoms of respiratory distress and voice change. Airway management should be take preference in patients having stridor before embarking on laryngeal examination with close Follow up.

References

Briem B, Thorvardsson O, Petersen H. Acute epiglottitis in Iceland 1983-2005. Auris Nasus Larynx. 2009;36:46-52.

Berger G, Landau T, Berger S, Finkelstein Y, Bernheim J, Ophir D. There is in incidence of adult acute epiglottitis and epiglottic abscess. Am J Otolaryngol. 2003;24:374-83.

Al-Qudah M, Shetty S, Alomari M, Alqdah M. Acute adult supraglottitis: current management and treatment. South Med J. 2010;103:800-4.

Hafidh MA, Sheahan P, Keogh I, Walsh RM. Acute epiglottitis in adults: a recent experience with 10 cases. J Laryngol Otol. 2006;120:310-3.

Lotfizadeh A, Chhetri DK. Viral supraglottitis in an adult. Ear Nose Throat J. 2009;88:768-70.

Alpay HC, Kaygusuz I, Karlidag T, Orhan I. Thermal burn of the larynx in an adult following hot water aspiration. Otolaryngol Head Neck Surg. 2008;139:164-5.

Alpay HC, Keles E, Orhan I, Yalcın S. Chemical injury of larynx after organophosphate ingestion. Otolaryngol Head Neck Surg. 2009;140:604-5.

Friedman M, Toriumi DM, Grybauskas V, Applebaum EL. Epiglottitis in the adults. A proposition for a clinical classification and therapeutic strategy. Ann OtolaryngolChirCervicofac. 1989;106:306-9.

Guldfred LA, Lyhne D, Becker BC. Acute epiglottitis: epidemiology, clinical presentation, management and outcome. J Laryngol Otol. 2008;122:818-23.

Isakson M, Hugosson S. Acute epiglottitis: epidemiology and Streptococcus pneumoniae serotype distribution in adults. J Laryngol Otol. 2011;125:390-3.

Frantz TD, Rasgon BM, Quesenberry CP., Jr Acute epiglottitis in adults. Analysis of 129 cases. JAMA. 1994;272:1358-60.

Katori H, Tsukuda M. Acute epiglottitis: analysis of factors associated with airway intervention. J Laryngol Otol. 2005;119:967-72.

Goto R, Miyabe K, Mori N. Thermal burn of the pharynx and larynx after swallowing hot milk. Auris Nasus Larynx. 2002;29:301-3.

Orhan I, Yilmaz F, Eken M. Laryngeal ulceration in Behcet’s Disease. Int J Phonosurg Laryngol. 2012;2:49-51.

Tsunoda K, Hozaki F, Aikawa J. Angioedema for the epiglottis associated with enalapril. Laryngoscope. 2000;110:2147-8.

Wong EY, Berkowitz RG. Acute epiglottitis in adults: the Royal Melbourne Hospital experience. ANZ J Surg. 2001;71:740-3.

Rizk SS, Kacker A, Komisar A. Need for tracheotomy is rare in patients with acute supraglottitis: Findings of a retrospective study. Ear Nose Throat J. 2000;79:952-7.

Chan KO, Pang YT, Tan KK. Acute epiglottitis in the tropics: is it an adult disease? J Laryngol Otol. 2001;115:715-8.

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Published

2023-01-10

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Original Research Articles