ABSTRACT
Objective To confirm the risk factors of poor prognosis in patients with severe acute epiglottitis by comparing symptoms and results of laboratory tests.Methods A total of 698 patients with acute epiglottitis from outpatient and emergency room from 1995 to 2014 were retrospectively studied.These patients were divided into severe or mild group as per the means of treatment of airway including invasive (n =115)and non-invasive (n =583).The past history,general conditions and laboratory tests were compared between the two groups by chi-square or t test;the spearman correlation between the degree of dyspnea and epiglottis edema was analyzed,and the risk factors of poor prognosis were detected by logistic regression.Results The ratio of male to female was 1.366/1.There was a high prevalence of sever acute epiglottitis in spring,winter and at night, respectively.More smokers were found in the severe group compared with the mild group (χ2 =41.957,P <0.01).Severe dyspnea and low PaO2 (r =0.573,P <0.01),but not the poor grading of epiglottis edema evaluated by pharyngo-fiberoscope (r =-0.024,P =0.525),were correlated with poor prognosis.Male (OR =1.84,95%CI:1.41 -3.22,P =0.001),an attack at night (OR =2.61,95%CI:1.98 -3.16),P =0.07), smoker (OR =1.63,95%CI:1.05 -3.39,P =0.04)and low PaO2 (OR =2.97,95%CI:1.58 -4.49,P =0.02)were independent risk factors for a poor prognosis.Conclusions Male,an attack at night,smoker and low PaO2 were independent risk factors for a poor prognosis of acute epiglottitis.A critical care should be given to patients with those risk factors,even their epiglottis edema was not very serious.
ABSTRACT
Scrub typhus is an endemic rickettsial disease with annual seasonal outbreak in Korea and its incidence is increasing. Recently, cases of scrub typhus with severe complications, such as septic shock, acute respiratory distress syndrome, acute renal failure, myocarditis, disseminated intravascular coagulation and meningitis have been increasingly reported. Acute epiglottitis is the one of potentially life- threatening scrub typhus related complications. Its initial clinical manifestations are sore throat, dysphagia or dyspnea. Although 22-62% of scrub typhus patients complain of sore throat, the etiology and optimal therapy are not yet known. We experienced 3 cases of scrub typhus-associated acute epiglottitis which rapidly responded to short-term corticosteroid administration.
Subject(s)
Humans , Acute Kidney Injury , Deglutition Disorders , Disseminated Intravascular Coagulation , Dyspnea , Epiglottitis , Incidence , Korea , Meningitis , Myocarditis , Pharyngitis , Respiratory Distress Syndrome , Scrub Typhus , Seasons , Shock, SepticABSTRACT
Scrub typhus is an endemic rickettsial disease with annual seasonal outbreak in Korea and its incidence is increasing. Recently, cases of scrub typhus with severe complications, such as septic shock, acute respiratory distress syndrome, acute renal failure, myocarditis, disseminated intravascular coagulation and meningitis have been increasingly reported. Acute epiglottitis is the one of potentially life- threatening scrub typhus related complications. Its initial clinical manifestations are sore throat, dysphagia or dyspnea. Although 22-62% of scrub typhus patients complain of sore throat, the etiology and optimal therapy are not yet known. We experienced 3 cases of scrub typhus-associated acute epiglottitis which rapidly responded to short-term corticosteroid administration.
Subject(s)
Humans , Acute Kidney Injury , Deglutition Disorders , Disseminated Intravascular Coagulation , Dyspnea , Epiglottitis , Incidence , Korea , Meningitis , Myocarditis , Pharyngitis , Respiratory Distress Syndrome , Scrub Typhus , Seasons , Shock, SepticABSTRACT
Acute epiglottitis is a local bacterial infection of the supraglottic area. Epiglottitis is generally caused by organisms which invoke an inflammatory response that develops rapid obstructive edema. The disease rarely progresses to abscess stage, either because medical intervention is sought or death by asphyxiation ensues. A 38-year-old, mentally ill but physically healthy woman died of airway obstruction caused by acute epiglottitis forming an abscess. She died unexpectedly and suddenly showing only minor nonspecific symptoms.
Subject(s)
Adult , Female , Humans , Abscess , Airway Obstruction , Bacterial Infections , Death, Sudden , Edema , Epiglottitis , Mentally Ill PersonsABSTRACT
1. Fifteen cases of acute primary epiglottitis were reviewed2. Young and middle-aged males are more susceptible to the disease than others3. Scarification and incision are the best therapeutic measures because they give relief promptly4. The average duration of hospitalization is 7 days5. Sulfadiazine given together with penicillin shorten the course of the disease to about 4 to 5 days. (Summary and Conclusions)
ABSTRACT
Acute epiglottitis is a life threatening inflammatory disease of the upper airway mainly in children, however, the recent reports about acute epiglottitis in adults are increasing. The common symptoms are sore throat, dysphagia, dyspnea and salivary drooling. As the laryngeal edema progresses, the patient sits up, leans forward, with the chin thrust forward, having obvious difficulty breathing. Early recognition and proper airway maintenance until the inflammatory edema subsides are essential steps to avoid a possible life threatening upper airway obstruction. We experienced two cases of acute epiglottitis with sitting up position, chin thrust forward, having dyspnea.