Acute epiglottitis in elderly age group: Our experiences at a tertiary care teaching hospital in Eastern India

Abstract

Background: Acute epiglottitis (AE) is a potentially life-threatening condition which can lead to airway obstruction. It is less commonly encountered in elderly persons but has more potential for poor outcome due to the indolent property of the clinical presentations. Objective: The objective of this study is to assess the clinical presentations and management of the elderly patients who visited the outpatient department of otorhinolaryngology with AE. Materials and Methods: This is a retrospective study done at a tertiary care teaching hospital from December 2014 to November 2019. We searched our electronic medical records for patient details with the diagnosis of AE. The patients of more than the age 50 years were included in this study. Results: A total of 21 patients were included in this study. The age ranges were from 52 to 78 years, with the mean age of the patients was 59.21 years. The most common symptom was sore throat (n = 19, 90.47%), followed by odynophagia (n = 13, 61.90%), fever (n = 9, 42.85%), change in voice (n = 7, 33.33%), drooling of saliva (n = 4%, 19.04%), and dyspnea (n = 4, 19.04%). Seventeen patients were treated conservatively with the help of broad-spectrum antibiotics and steroids without the requirement of definite airway intervention. Two patients were intubated, one underwent tracheostomy and one underwent cricothyrotomy. Conclusion: In elderly patients with AE, sore throat is the most common clinical symptom, but stridor is less common. Conservative management is commonly utilized for the management of AE in elderly patients. If AE left untreated, can progress to life-threatening airway obstruction and so the diagnosis not be missed.