Acute epiglottitis in adults.

Abstract

Abstract We retrospectively reviewed the medical records on all cases of acute epiglottitis in adults from each of the hospitals in Rhode Island and from the state medical examiner's office over an eight-year period (1975–1982). We found 56 cases — an annual incidence of 9.7 cases per million adults. A significant increase occurred in the last two study years. Indirect laryngoscopy proved to be more reliable in making a diagnosis than did x-ray films of the neck; all of 41 indirect examinations were performed without complications. Twenty-three percent (6 of 26) of patients in whom blood cultures had been obtained had bacteremia, all with Hemophilus influenzae. Bacteremia was associated with a high risk of airway obstruction. Four patients died, all from acute airway obstruction, for a mortality rate of 7.1 percent — a rate significantly higher than the current rate among children. Two deaths occurred after admission, while the patients were being observed without an artificial airway. We conclude that th...