Document Detail

Epiglottitis in the adult patient.
MedLine Citation:
PMID:  18931398     Owner:  NLM     Status:  MEDLINE    
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.
R B Mathoera; P C Wever; F R C van Dorsten; S G T Balter; C P C de Jager
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Netherlands journal of medicine     Volume:  66     ISSN:  0300-2977     ISO Abbreviation:  Neth J Med     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2009-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0356133     Medline TA:  Neth J Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  373-7     Citation Subset:  IM    
Department of Intensive Care Medicine, 's-Hertogenbosch, the Netherlands.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Diagnosis, Differential
Epiglottitis / diagnosis*,  microbiology,  therapy
Haemophilus Infections / diagnosis*,  microbiology,  therapy
Haemophilus influenzae / isolation & purification
Middle Aged
Tomography, X-Ray Computed
Reg. No./Substance:
0/Anti-Bacterial Agents

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