J Korean Soc Emerg Med.  2016 Feb;27(1):126-133. 10.0000/jksem.2016.27.1.126.

Clinical Features of Acute Epiglottitis in Adults in the Emergency Department

• You KM
• Kwon WY
• Suh GJ
• Kim KS
• Kim JS
• Park MJ

• KMID: 2191646
• DOI: http://doi.org/10.0000/jksem.2016.27.1.126

Abstract

PURPOSE
Acute epiglottitis is a potentially fatal condition that can result in airway obstruction. The aim of this study is to examine the clinical features of adult patients who visited the emergency department (ED) with acute epiglottitis.
METHODS
This retrospective observational study was conducted at a single tertiary hospital ED from November 2005 to October 2015. We searched our electronic medical records (EMR) system for a diagnosis of "acute epiglottitis" and selected those patients who visited the ED.
RESULTS
A total of 28 patients were included. There was no pediatric case with acute epiglottitis during the study period. The mean age of the patients was 58.0+/-14.8 years. The peak incidences were in the sixth (n=7, 25.0%) and eighth (n=8, 28.6%) decades. The male-to-female ratio was 2.1:1. The most common symptom was sore throat (n=23, 82.1%), followed by dyspnea (n=15, 53.6%), hoarseness (n=7, 25.0%), fever (n=6, 21%), and dysphagia (n=5, 17.9%). The diagnosis of acute epiglottitis was confirmed when edema and hyperemia of the epiglottis were visualized by laryngoscopy. Twenty-six patients were treated conservatively with antibiotics and steroids without definite airway management. Two patients were intubated, but no patients required tracheostomy.
CONCLUSION
In adult patients with acute epiglottitis, sore throat and dyspnea were the most common symptoms but fever was infrequent. Most patients improved with conservative management only. Definite airway management was required in only two patients in whom endotracheal intubations were performed successfully in the ED by emergency physicians, and surgical airway management was not required.

Keyword

Epiglottitis; Emergency medical services; Fever; Intratracheal Intubation

MeSH Terms

Adult*
Airway Management
Airway Obstruction
Anti-Bacterial Agents
Deglutition Disorders
Diagnosis
Dyspnea
Edema
Electronic Health Records
Emergencies*
Emergency Medical Services
Emergency Service, Hospital*
Epiglottis
Epiglottitis*
Fever
Hoarseness
Humans
Hyperemia
Incidence
Intubation, Intratracheal
Laryngoscopy
Observational Study
Pharyngitis
Retrospective Studies
Steroids
Tertiary Care Centers
Tracheostomy
Anti-Bacterial Agents
Steroids