Adult supraglottitis: a potential airway emergency that can present in primary care.

Abstract

Adult supraglottitis is a serious and potentially life-threatening condition, characterised by inflammation of the supraglottic structures of the larynx, namely the arytenoids, the false vocal cords, the laryngeal ventricles, the aryepiglottic folds and the epiglottis. This condition presents a diagnostic challenge owing to the non-specific nature of the clinical presentation. Patients with supraglottitis can rapidly develop airway compromise due to swelling of the supraglottic structures, potentially leading to respiratory arrest. In infective cases of supraglottitis, the infection can spread to adjacent structures, resulting in parapharyngeal abscess, epiglottic abscess or Lemierre Syndrome (thrombosis of the internal jugular vein). Although the incidence of supraglottitis has decreased in children since the introduction of the Haemophilus influenza type B (HiB) vaccine, most epidemiological studies suggest the incidence in adults has stayed the same1 or increased,2 with figures for the annual incidence varying from 1.1 to 4.7 per …