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Acute epiglottitis: epidemiology, clinical presentation, management and outcome

Published online by Cambridge University Press:  25 September 2007

L-A Guldfred ,
D Lyhne  and
B C Becker
L-A Guldfred*
Affiliation:
Department of Otolaryngology, Roskilde County Hospital, Denmark
D Lyhne
Affiliation:
Department of Otolaryngology, Roskilde County Hospital, Denmark
B C Becker
Affiliation:
Department of Otolaryngology, Roskilde County Hospital, Denmark
*
Address for correspondence: Dr Liviu-Adelin Guldfred, Moseroejel 4, 2670 Greve, Denmark. E-mail: liviu@hlaug.dk
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Abstract

Aims:

To describe the incidence trends, clinical presentation, management and outcome of acute epiglottitis in a Danish population after the introduction of Haemophilus influenzae type b vaccine.

Methods:

Retrospective review of the health records of all patients discharged with a diagnosis of acute epiglottitis from the otolaryngology department, Roskilde County Hospital, Denmark, from 1996 to 2005.

Results:

One infant and 34 adults were identified. The incidence of acute epiglottitis in children was 0.02 cases/100 000/year. Before introduction of the H influenzae type b vaccination (1983–1992), the mean national incidence of acute epiglottitis was 4.9 cases/100 000/year. The incidence of acute epiglottitis in adults was constant, with a mean value of 1.9 cases/100 000/year. Twenty-nine per cent of the patients required an artificial airway, and respiratory distress was found to be associated with airway intervention (p = 0.010). All patients recovered completely.

Conclusions:

In the H influenzae type b vaccine era, acute epiglottitis in children has almost disappeared. The incidence in the adult population has been constant. A discriminate approach to airway management seems safe in adults.

Keywords

Haemophilus Influenzae VaccinesEpiglottisChildImmunisationDenmark
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 8 , August 2008 , pp. 818 - 823
Copyright
Copyright © JLO (1984) Limited 2008

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References

1Carey, MJ. Epiglottitis in adults. Am J Emerg Med 1996;14:421–4CrossRefGoogle ScholarPubMed
2Mayo-Smith, MF, Spinale, JW, Donskey, CJ, Yukawa, M, Li, RH, Schiffman, FJ. Acute epiglottitis. An 18-year experience in Rhode Island. Chest 1995;108:1640–7CrossRefGoogle ScholarPubMed
3Midwinter, KI, Hodgson, D, Yardley, M. Paediatric epiglottitis: the influence of the Haemophilus influenzae b vaccine, a ten-year review in the Sheffield region. Clin Otolaryngol Allied Sci 1999;24:447–8CrossRefGoogle ScholarPubMed
4McVernon, J, Slack, MP, Ramsay, ME. Changes in the epidemiology of epiglottitis following introduction of Haemophilus influenzae type b (Hib) conjugate vaccines in England: a comparison of two data sources. Epidemiol Infect 2006;134:570–2CrossRefGoogle Scholar
5Faden, H. The dramatic change in the epidemiology of pediatric epiglottitis. Pediatr Emerg Care 2006;22:443–4CrossRefGoogle ScholarPubMed
6Torkkeli, T, Ruoppi, P, Nuutinen, J, Kari, A. Changed clinical course and current treatment of acute epiglottitis in adults: a 12-year experience. Laryngoscope 1994;104:1503–6CrossRefGoogle Scholar
7Berger, G, Landau, T, Berger, S, Finkelstein, Y, Bernheim, J, Ophir, D. The rising incidence of adult acute epiglottitis and epiglottic abscess. Am J Otolaryngol 2003;24:374–83CrossRefGoogle ScholarPubMed
8Garner, D, Weston, V. Effectiveness of vaccination for Haemophilus influenzae type b. Lancet 2003;361:395–6CrossRefGoogle ScholarPubMed
9Freedman, LS. The use of a Kolmogorov-Smirnov type statistic in testing hypotheses about seasonal variation. J Epidemiol Community Health 1979;33:223–8CrossRefGoogle ScholarPubMed
10Hopkins, A, Lahiri, T, Salerno, R, Heath, B. Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics 2006;118:1418–21CrossRefGoogle ScholarPubMed
11Shah, RK, Roberson, DW, Jones, DT. Epiglottitis in the Hemophilus influenzae type B vaccine era: changing trends. Laryngoscope 2004;114:557–60CrossRefGoogle ScholarPubMed
12Garpenholt, O, Hugosson, S, Fredlund, H, Bodin, L, Olcen, P. Epiglottitis in Sweden before and after introduction of vaccination against Haemophilus influenzae type b. Pediatr Infect Dis J 1999;18:490–3CrossRefGoogle ScholarPubMed
13Alho, OP, Jokinen, K, Pirila, T, Ilo, A, Oja, H. Acute epiglottitis and infant conjugate Haemophilus influenzae type b vaccination in northern Finland. Arch Otolaryngol Head Neck Surg 1995;121:898–902CrossRefGoogle ScholarPubMed
14Muhlemann, K, Alexander, ER, Pepe, M, Weiss, NS, Schopfer, K. Invasive Haemophilus influenzae disease and epiglottitis among Swiss children from 1980 to 1993: evidence for herd immunity among older age groups. The Swiss Haemophilus Influenzae Study Group. Scand J Infect Dis 1996;28:265–8CrossRefGoogle ScholarPubMed
15McEwan, J, Giridharan, W, Clarke, RW, Shears, P. Paediatric acute epiglottitis: not a disappearing entity. Int J Pediatr Otorhinolaryngol 2003;67:317–21CrossRefGoogle Scholar
16Heath, PT, Booy, R, Azzopardi, HJ, Slack, MP, Bowen-Morris, J, Griffiths, H et al. Antibody concentration and clinical protection after Hib conjugate vaccination in the United Kingdom. JAMA 2000;284:2334–40CrossRefGoogle ScholarPubMed
17Tanner, K, Fitzsimmons, G, Carrol, ED, Flood, TJ, Clark, JE. Haemophilus influenzae type b epiglottitis as a cause of acute upper airways obstruction in children. BMJ 2002;325:1099–100CrossRefGoogle ScholarPubMed
18Frantz, TD, Rasgon, BM, Quesenberry, CP Jr. Acute epiglottitis in adults. Analysis of 129 cases. JAMA 1994;272:1358–60CrossRefGoogle ScholarPubMed
19Kass, EG, McFadden, EA, Jacobson, S, Toohill, RJ. Acute epiglottitis in the adult: experience with a seasonal presentation. Laryngoscope 1993;103:841–4CrossRefGoogle ScholarPubMed
20Hebert, PC, Ducic, Y, Boisvert, D, Lamothe, A. Adult epiglottitis in a Canadian setting. Laryngoscope 1998;108:64–9CrossRefGoogle Scholar
21Katori, H, Tsukuda, M. Acute epiglottitis: analysis of factors associated with airway intervention. J Laryngol Otol 2005;119:967–72CrossRefGoogle ScholarPubMed
22Cantrell, RW, Bell, RA, Morioka, WT. Acute epiglottitis: intubation versus tracheostomy. Laryngoscope 1978;88:994–1005CrossRefGoogle ScholarPubMed
23Mayo-Smith, MF, Hirsch, PJ, Wodzinski, SF, Schiffman, FJ. Acute epiglottitis in adults. An eight-year experience in the state of Rhode Island. N Engl J Med 1986;314:1133–9Google ScholarPubMed
24Wolf, M, Strauss, B, Kronenberg, J, Leventon, G. Conservative management of adult epiglottitis. Laryngoscope 1990;100:183–5CrossRefGoogle ScholarPubMed
25Dort, JC, Frohlich, AM, Tate, RB. Acute epiglottitis in adults: diagnosis and treatment in 43 patients. J Otolaryngol 1994;23:281–5Google ScholarPubMed