Skip to main content

Advertisement

Log in

Diagnosis and management of supraglottitis (Epiglottitis)

  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Acute supraglottitis is a serious, potentially fatal infection in both adults and children. Haemophilus influenzae type b (Hib) is the most common cause in children, even in this era of the Hib vaccine. Most cases of acute supraglottitis in adults are thought to be caused by other bacterial organisms, viral or combined viral-bacterial infections, and noninfectious etiologies. Early visualization of the larynx is essential, as is establishment of a secure airway in selected cases. Most cases will respond to intravenous antibiotic therapy and will not require an artificial airway. Admission to an area of high-intensity nursing is essential. Daily laryngoscopy is necessary to monitor response to treatment. Although the incidence of acute supraglottitis in children has decreased, isolated cases will be encountered and demand high vigilance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Carey MJ: Epiglottitis in adults. Am J Emerg Med 1996, 14:421–424.

    Article  PubMed  CAS  Google Scholar 

  2. Mayo-Smith MF, Spindale JW, Donskey CJ, et al.: Acute epiglottitis. An 18 year experience in Rhode Island. Chest 1995, 108:1640–1647.

    Article  PubMed  CAS  Google Scholar 

  3. Midwinter KI, Hodgson D, Yardley M: Paediatric epiglottitis: the influence of the Haemophilus influenza type b vaccine, a ten year review in the Sheffield region. Clin Otolaryngol Allied Sci 1999, 24:447–448.

    Article  PubMed  CAS  Google Scholar 

  4. McVernon J, Slack MP, Ramsay ME: Changes in the epidemiology of epiglottitis following the introduction of Haemophilus influenza type b conjugate vaccines in England: a comparison of two data sources. Epidemiol Infect 2006, 134:570–572.

    Article  PubMed  CAS  Google Scholar 

  5. Faden H: The dramatic change in the epidemiology of paediatric epiglottitis. Pediatr Emerg Care 2006, 22:443–444.

    Article  PubMed  Google Scholar 

  6. Torkkeli T, Ruoppi P, Nuutinen J, Kari A: Changed clinical course and current treatment of acute epiglottitis in adults: a 12 year experience. Laryngoscope 1994, 104:1503–1506.

    Article  PubMed  CAS  Google Scholar 

  7. Hebert PC, Ducic Y, Boisvert D, Lamothe A: Adult epiglottitis in a Canadian setting. Laryngoscope 1998, 108:64–69.

    Article  PubMed  CAS  Google Scholar 

  8. Berger G, Landau T, Berger S, et al.: The rising incidence of adult acute epiglottitis and epiglottitis abscess. Am J Otolaryngol 2003, 24:374–383.

    Article  PubMed  Google Scholar 

  9. Garner D, Weston V: effectiveness of vaccination for Haemophilus influenza type b. Lancet 2003, 361:395–396.

    Article  PubMed  Google Scholar 

  10. Tanner K, Fitzsimmons G, Carrol ED, Clark JE: Haemophilus influenza type b epiglottitis as a cause of acute airway obstruction in children. BMJ 2002, 325:1099–1100.

    Article  PubMed  CAS  Google Scholar 

  11. Shah RK, Robertson DW, Jones DT: Epiglottitis in the Hemophilus influenza type b vaccine era: changing trends. Laryngoscope 2004, 114:557–560.

    Article  PubMed  Google Scholar 

  12. Guldfred LA, Lyhne D, Becker BC: Acute epiglottitis: epidemiology, clinical presentation, management and outcome. J Laryngol Otol 2007, Sep 25:1–6 (Epub ahead of print).

    Google Scholar 

  13. Trollfors B, Nylen O, Strangert K: Acute epiglottitis in adults and children in Sweden 1981–1983. Arch Dis Child 1990, 65:491–494.

    PubMed  CAS  Google Scholar 

  14. Madhotra D, Fenton JE, Makura ZG, et al.: Airway intervention in adult supraglottitis. Ir J Med Sci 2004, 173:197–199.

    PubMed  CAS  Google Scholar 

  15. Senior BA, Radkowski D, McArthur C, et al.: Changing patterns in pediatric supraglottitis: a multi-institutional review, 1980–1992. Laryngoscope 1994, 104:1314–1322.

    Article  PubMed  CAS  Google Scholar 

  16. Ward MA: Emergency department management of acute respiratory infections. Sem Respir Infect 2002, 17:65–71.

    Article  Google Scholar 

  17. Rosbe KW, Perez-Atayde AR, Roberson DW, Kenna M: Pathology forum: quiz case 1. Diagnosis: posttransplant lymphoproliferative disease (PTLD) of the epiglottis. Arch Otolaryngol Head Neck Surg 2000, 126:1153; discussion, 1157–1158.

    PubMed  CAS  Google Scholar 

  18. Devlin B, Glochin K, Adair R: Paediatric airway emergencies in Northern Ireland, 1990–2003. J Laryngol Otol 2007, 121:659–663.

    Article  PubMed  CAS  Google Scholar 

  19. Holmes SJ, Granoff DM: The biology of Haemophilus influenza type b vaccination failure. J Infect Dis 1992, 165:S121–S128.

    PubMed  Google Scholar 

  20. Heath PT, Booy R, Azzopardi HJ, et al.: Antibody concentration and clinical protection after Hib conjugate vaccination in the United Kingdom. JAMA 2000, 284:2334–2340.

    Article  PubMed  CAS  Google Scholar 

  21. McCaig LF, Hughes JM: Trends in antimicrobial drug prescribing among office based physicians in the United States. JAMA 1995, 273:214–219.

    Article  PubMed  CAS  Google Scholar 

  22. Hafidh MA, Sheahan P, Keogh IJ, McConn Walsh R: Acute epiglottitis in adults: a recent experience with 10 cases. J Laryngol Otol 2006, 120:310–313.

    Article  PubMed  CAS  Google Scholar 

  23. Gonzalez Valdepena H, Wald ER, Rose E, et al.: Epiglottitis and Haemophilus influenzae immunization: the Pittsburgh experience—a five year review. Paediatrics 1995, 96:424–427.

    CAS  Google Scholar 

  24. Rafei K, Lichenstein R: Airway infectious disease emergencies. Pediatr Clin North Am 2006, 53:215–242.

    Article  PubMed  Google Scholar 

  25. Kilham H, Gillis J, Benjamin B: Severe upper airway obstruction. Pediatr Clin North Am 1987, 34:1–14.

    PubMed  CAS  Google Scholar 

  26. Cantrell RW, Bell RA, Morioka WT: Acute epiglottitis: intubation versus tracheostomy. Laryngoscope 1978, 88:994–1005.

    Article  PubMed  CAS  Google Scholar 

  27. Wolf M, Strauss B, Kronenberg J, Leventon G: Conservative management of adults epiglottitis. Laryngoscope 1990, 100:183–185.

    PubMed  CAS  Google Scholar 

  28. Ames WA, Ward VM, Tranter RM, Street M: Adult epiglottitis: an underdiagnosed, life threatening condition. Br J Anaesth 2000, 85:795–797.

    Article  PubMed  CAS  Google Scholar 

  29. Local ethical committees: council approves revised report. BMJ 1981, 282:1010.

  30. Baxter FJ, Dunn GL: Acute epiglottitis in adults. Can J Anesth 1988, 35:4:428–435.

    Article  PubMed  CAS  Google Scholar 

  31. Katori H, Tsukuda M: Acute epiglottitis: analysis of factors associated with airway intervention. J Laryngol Otol 2005, 119:967–972.

    PubMed  Google Scholar 

  32. Andreassen UK, Baer S, Nielsen TG, et al.: Acute epiglottitis: 25 years experience with nasotracheal intubation, current management policy and future trends. J Laryngol Otol 1992, 106:1072–1075.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John E. Fenton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Glynn, F., Fenton, J.E. Diagnosis and management of supraglottitis (Epiglottitis). Curr Infect Dis Rep 10, 200–204 (2008). https://doi.org/10.1007/s11908-008-0033-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11908-008-0033-8

Keywords

Navigation