Adult Epiglottitis as an Often Overlooked, Life-threatening Condition Requiring Special Airway Consideration; a Case Report
Archives of Academic Emergency Medicine,
Vol. 12 No. 1 (2024),
1 January 2024
,
Page e69
https://doi.org/10.22037/aaem.v13i1.2351
Abstract
After the implementation of vaccination against Haemophilus Influenza Type B (Hib), adult patients comprise the majority of patients with acute epiglottitis. Its presentation with stridor mandates swift recognition and intervention to prevent airway compromise and mortality. Here, we present a case of a 44-year-old male with diabetes mellitus who presented with acute onset of shortness of breath and stridor following days of throat soreness and fever. Initial treatment for suspected anaphylaxis provided partial relief, and emergency department evaluation revealed characteristic signs of acute epiglottitis on lateral soft tissue neck x-ray and nasopharyngoscopy. Treatment was initiated with intravenous ampicillin/sulbactam and dexamethasone, and the patient was discharged home on day 4. This case underscores the critical importance of maintaining a high index of suspicion for acute epiglottitis in adults presenting with stridor and respiratory distress. Prompt recognition, airway management, and appropriate antibiotic therapy are paramount in mitigating the potentially devastating outcomes associated with this condition. As demographics shift and vaccination impacts epidemiology, heightened vigilance in emergency settings is essential to improve outcomes in adult patients with acute epiglottitis.
- Epiglottitis
- Haemophilus vaccines
- Respiratory sounds
- Airway management
- Haemophilus influenzae type b
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References
Mathoera R, Wever P, Van Dorsten F, Balter S, De Jager C. Epiglottitis in the adult patient. Neth J Med. 2008;66(9):373-7.
Guardiani E, Bliss M, Harley E. Supraglottitis in the era following widespread immunization against Haemophilus influenzae type B: evolving principles in diagnosis and management. The Laryngoscope. 2010;120(11):2183-8.
Lindquist B, Zachariah S, Kulkarni A. Adult epiglottitis: a case series. The Permanente Journal. 2017;21.
Guldfred L, Lyhne D, Becker B. Acute epiglottitis: epidemiology, clinical presentation, management and outcome. The Journal of Laryngology & Otology. 2008;122(8):818-23.
Hanna J, Brauer PR, Berson E, Mehra S. Adult epiglottitis: trends and predictors of mortality in over 30 thousand cases from 2007 to 2014. The Laryngoscope. 2019;129(5):1107-12.
Levinson W. Review of Medical Microbiology and Immunology: McGraw-Hill Education; 2016.
Woods CR. Epiglottitis (supraglottitis): management. U: UpToDate, Fleisher GR, Walls RM, Isaacson GC ed UpToDate [Internet] UpToDate. 2021.
Dowdy RA, Cornelius BW. Medical management of epiglottitis. Anesthesia progress. 2020;67(2):90-7.
Ward MA, editor Emergency department management of acute respiratory infections. Seminars in respiratory infections; 2002.
Kissoon N, Mitchell I. Adverse effects of racemic epinephrine in epiglottitis. Pediatric Emergency Care. 1985;1(3):143-4.
Wiebe K, Rowe BH. Nebulized racemic epinephrine used in the treatment of severe asthmatic exacerbation: a case report and literature review. Canadian Journal of Emergency Medicine. 2007;9(4):304-8.
Shah RK, Stocks C. Epiglottitis in the United States: national trends, variances, prognosis, and management. The Laryngoscope. 2010;120(6):1256-62.
Vermelis A, Mateijsen N, Giebelen D, Meeusen V, Wong D, Van Zundert A. Successful use of videolaryngoscopy in an adult patient with acute epiglottitis: a case report. Acta anaesthesiologica belgica. 2010;61(2):67-70.
Riffat F, Jefferson N, Bari N, McGuinness J. Acute supraglottitis in adults. Annals of Otology, Rhinology & Laryngology. 2011;120(5):296-9.
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