1/7. Paediatric acute epiglottitis re-visited.INTRODUCTION: Paediatric acute epiglottitis is rare in asia. The National University Hospital in singapore has seen only two cases of paediatric acute epiglottitis in the last 10 years. The topic is re-visited here to remind physicians of its acutely dramatic progression. CLINICAL PICTURE: Both boys presented with a viral prodrome which progressed within hours to life-threatening upper airway obstruction. Examination revealed an inflamed epiglottitis. Treatment: They were successfully intubated and treated with intravenous antibiotics. OUTCOME: Both recovered uneventfully. CONCLUSION: Paediatric acute epiglottitis has declined markedly in the West with widespread vaccination against HiB. In contrast, the incidence of invasive HiB disease in asia has always been low despite limited vaccination. Clinicians must remain vigilant of the possibility of acute epiglottitis in a child with "flu".- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Tenderness over the hyoid bone can indicate epiglottitis in adults.adult acute epiglottitis is a rare but life-threatening disease caused by obstruction of the airway. The symptoms and signs of this disease may be nonspecific without apparent airway compromise. We encountered 3 consecutive cases of adult patients with this disease in a single 5-month period in one physician's office. In all cases, physical examination revealed tenderness of the anterior neck over the hyoid bone. These observations assisted us in identifying this rare disease quickly. We suggest that tenderness over the hyoid bone should raise suspicion of adult acute epiglottitis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Complications in the use of prochlorperazine.This case presentation is of a patient who had the clinical appearance of epiglottitis, but actually had an oro-pharyngeal dystonic reaction to prochlorperazine. The intent of the discussion is to alert physicians that the appearance of epiglottis can occur from causes other than infection and that a surgical airway should not be the first thought when such a case arises.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Caustic and thermal epiglottitis in the adult.The presence of dysphagia, drooling, and stridor in an adult subsequent to thermal or caustic injury should alert the treating physician to the possibility of injury to the supraglottic structures with resultant epiglottitis. These adults possess many of the features seen in acute infectious epiglottitis and should be handled with the same consideration for potential upper airway obstruction. Epiglottic injuries of this type should be suspected in adults with mental disorders or communication difficulties.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Unique case presentations of acute epiglottic swelling and a protocol for acute airway compromise.Acute epiglottitis is a well-described life-threatening disease. Since the generalized use of the haemophilus influenzae type b (HIB) vaccine, presentations of this disorder have decreased dramatically in children. Presentations of this and other acute epiglottic swelling can vary remarkably and may easily be misdiagnosed by physicians who have little or no experience with the acutely obstructed airway. Early suspicion and a proper evaluation is mandatory to prevent a life-threatening crisis. Six patients are presented with unusual presentations of acute epiglottic swelling from differing etiologies; these include the following: case 1, recurrent epiglottitis; case 2, chronic epiglottitis; case 3, traumatic epiglottitis; case 4, caustic ingestion; and cases 5 and 6, simultaneous infection of family members. Because the incidence of acute epiglottitis is decreasing, it has become rare at most institutions. To help primary care and emergency room physicians, a formal written protocol should be available at medical facilities that might be faced with patients presenting with acute airway obstruction. An "acute airway obstruction protocol" used successfully for the last decade is offered. Use of such a written document might be life-saving for patients with impending upper airway obstruction. The otolaryngologist is a key member of the recommended multidisciplinary team.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
6/7. Simultaneous uvulitis and epiglottitis in adults.The emergency physician must be aware of the varied ways in which epiglottitis can present. This report discusses two adult patients who presented with symptoms and signs indicative of uvulitis who were found to have associated epiglottitis. Neither patient reported respiratory difficulty but both experienced significant pain upon swallowing and were febrile with an enlarged, erythematous uvula. Management consisted of close observation and treatment with an intravenous antibiotic and corticosteroid. The emergency physician should consider the possibility of coexistent epiglottitis in the adult patient who presents with uvulitis.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
7/7. Thermal epiglottitis in adults: a new complication of illicit drug use.Four cases of acute epiglottitis due to thermal injury were identified in a larger study of 407 cases of epiglottitis in rhode island from 1975 through 1992. All occurred in young adults (aged 22-33 yr) and were caused by the inhalation of heated objects when smoking illicit drugs (a tip of a marijuana cigarette in 1 case and metal pieces from crack cocaine pipes in 3 cases). Symptoms, signs, and X-ray and laryngoscopic findings were similar to infectious epiglottitis. All recovered with observation and intravenous antibiotics; none required intubation. Emergency physicians should be aware of this etiology when managing young adults who present with acute epiglottitis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |