Incidence Of Acute Epiglottitis Research Articles

Rising Incidence of Acute Epiglottitis in Eastern China: An Eight-Year Retrospective Study and Its Association with the 24 Solar Terms.

This study aimed to investigate the clinical characteristics of acute epiglottitis (AE) patients in East China and examine the correlation between the incidence of AE and the 24 solar terms (24 STs). A retrospective, observational study was conducted on patients diagnosed with AE between January 2014 and December 2021 at a single-center medical institution in East China. The clinical characteristics of patients with AE and their correlation with the 24 STs were investigated. A total of 287 patients with AE were included in this study, among which there were 179 males (62.37%) and 108 females (37.63%), with a mean age of 47.79 ± 13.83 years (range 16-87 years). Of these patients, 100 (34.84%) had at least one comorbidity and the most common comorbidities were hypertension, smoking and type 2 diabetes. The duration of hospitalization was 3 days (IQR, 1-16 days). All patients, except for one who required tracheal intubation, were cured with intravenous antibiotic administration and the combined use of corticosteroids. The incidence of AE showed significant fluctuations between the 24 STs and the highest number of cases occurred during the Summer solstice (24 cases, 8.36%). The incidence of AE was seen to increase annually in this study. The main features of AE are sore throat, dysphagia, odynophagia and fever, which may be accompanied by inflammation in surrounding areas. A clear correlation exists between the incidence of AE and the fluctuations within the 24 STs, notably with the peak incidence observed during the Summer solstice, which approximately corresponds to June 21 to July 7 in the Gregorian calendar.

The effects of PM 2.5 and air quality index on the emergency of otolaryngology

Objective:To discuss the effects of PM 2.5 and air quality index on the emergency of otolaryngology. Method:Collect in 2015 Beijing tongren hospital emergency department patients with acute otitis media, epistaxis, acute epiglottitis as well as the same time Beijing AQI value and the PM 2.5 density data as the experimental group 1, chooses in 2015 first Affiliated Hospital of Hebei North University similar patient as well as the same time Zhangjiakou AQI value and the PM 2.5 density as the experimental group 2. Statistics the quantity of each sickness of two groups, and the relationships with PM 2.5 and AQI value; Group all data by AQI value and statistics the differences in the incidence rates of each group. Result:The number of cases of acute otitis media and epistaxis in the 2 experimental group were all correlated with the change of PM 2.5 and AQI value, and the correlation was positive between the two groups, However, the incidence of acute epiglottitis was not significantly correlated with the concentration of PM 2.5 and AQI, and there was no significant correlation between the two. The air quality when severe and more pollution when the number of the cases of acute otitis media and epistaxis compared with good air quality for the number of P<0.05, the difference was statistically significant. Conclusion:The increase of PM 2.5 concentration and AQI index is a health risk factor for acute otitis media and epistaxis.

Acute epiglottitis: epidemiology and Streptococcus pneumoniae serotype distribution in adults

We studied the incidence and bacterial epidemiology of acute epiglottitis presenting in the first 16 years following the introduction of general childhood vaccination against Haemophilus influenzae type b. Our main objectives were to analyse (1) the incidence of Streptococcus pneumoniae epiglottitis in adults and (2) the distribution of pneumococcal serotypes involved. The medical records of patients with acute epiglottitis (International Classification of Disease code J05.1) were investigated. Streptococcus pneumoniae serotyping was performed using gel precipitation. The overall incidence of acute epiglottitis was 0.98 cases/100,000/year, compared with 4.5 cases/100,000/year before the vaccination programme. The incidence was reduced both in children and adults, compared with pre-vaccination values. However, the incidence of Streptococcus pneumoniae epiglottitis in adults increased from 0.1 to 0.28 cases/100,000/year over the same time period. The causative agent was Streptococcus pneumoniae in 10 adults. Nine of 10 pneumococcal strains could be serotyped. All but one serotype is represented in the 23-valent pneumococcal polysaccharide vaccine (PPV23) used in adults. In acute epiglottitis, now a disease of adults, the most important bacterial aetiology is Streptococcus pneumoniae. The serotype distribution found in this study indicates that the infection is preventable by PPV-23 vaccination with the 23-valent polysaccharide vaccine.

Acute epiglottitis: epidemiology, clinical presentation, management and outcome

To describe the incidence trends, clinical presentation, management and outcome of acute epiglottitis in a Danish population after the introduction of Haemophilus influenzae type b vaccine. Retrospective review of the health records of all patients discharged with a diagnosis of acute epiglottitis from the otolaryngology department, Roskilde County Hospital, Denmark, from 1996 to 2005. One infant and 34 adults were identified. The incidence of acute epiglottitis in children was 0.02 cases/100,000/year. Before introduction of the H influenzae type b vaccination (1983-1992), the mean national incidence of acute epiglottitis was 4.9 cases/100,000/year. The incidence of acute epiglottitis in adults was constant, with a mean value of 1.9 cases/100,000/year. Twenty-nine per cent of the patients required an artificial airway, and respiratory distress was found to be associated with airway intervention (p = 0.010). All patients recovered completely. In the H influenzae type b vaccine era, acute epiglottitis in children has almost disappeared. The incidence in the adult population has been constant. A discriminate approach to airway management seems safe in adults.

Acute epiglottitis: analysis of factors associated with airway intervention

We reviewed acute epiglottitis (AE) and identified factors associated with airway intervention. This report was a retrospective review of patients with AE and compared with factors associated with airway intervention. We reviewed 96 patients who were diagnosed with AE in our hospitals in Japan. Ninety-two (96 per cent) patients were adults, and no seasonal variation in the incidence of AE was encountered. Eight (8 per cent) patients had tracheostomy and endotracheal intubation had not been done. We found that symptoms of stridor and muffled voice, a rapid clinical course, and diabetes mellitus were the factors associated with airway intervention. Extremely severe swelling of the epiglottis such that only less than half of the posterior vocal fold (scope classification (SC): III) could be seen, and extension of the swelling to the arytenoids (SC: B) were the two factors that were strongly associated with airway intervention.

The rising incidence of adult acute epiglottitis and epiglottic abscess

Objective To examine preliminary observations that the incidence of adult acute epiglottitis has risen between 1986 and 2000. Materials and methods Demographics, annual and seasonal occurrences, clinical presentation, diagnostic procedures, treatment, airway management, and complications of 116 consecutive adult patients with laryngoscopically confirmed acute epiglottitis are presented. Results The mean annual incidence of acute epiglottitis per 100,000 adults significantly increased from 0.88 (from 1986–1990) to 2.1 (from 1991–1995) and to 3.1 (from 1996–2000) ( P < .001). This rise seems to be unrelated to Haemophilus influenzae type b infection but related to miscellaneous pathogenic bacteria. During these periods, the number of epiglottic abscesses increased concomitantly with the rise in the incidence of acute epiglottitis (from 4/14 episodes [29%], to 8/38 [21%], and to 16/66 [24%], respectively), showing a relatively constant ratio between both phenomena ( P = .843). Twenty-five patients (21%) underwent airway intervention, 16 because of objective respiratory distress and 9 because of imminent respiratory obstruction. Stepwise logistic regression showed that drooling, diabetes mellitus, rapid onset of symptoms, and abscess formation were associated with airway obstruction. Diverse origins for the epiglottic abscess, either from coalescent epiglottic infection or from mucopyocele of the tongue base, are suggested. Conclusions A rise in the incidence of acute epiglottitis and a concomitant rise in the number of epiglottic abscesses were established. Although the course of acute epiglottitis is often benign and can be safely treated with a conservative management approach, delayed airway obstruction may develop from a few hours to days after admission.

Epidemiology of invasive Haemophilus influenzae type b disease in Scandinavia

In all Scandinavian countries, most invasive Haemophilus influenzae type b (Hib) infections occur before the age of 5 years. The age-specific incidence of Hib meningitis in this age group is 26–35/100 000 per year in Denmark, Norway, Finland and Sweden and about 43/100 000 per year in Iceland. Of the meningitis patients, approximately 60% are younger than 2 years but Hib meningitis also occurs in older children and adults. The case fatality rate is low (1–3%) in children but the rate of neurological sequelae is considerable. The incidence of acute epiglottitis, the other main manifestation of Hib disease, varies considerably. In Sweden, four studies have shown a very high incidence in the age group 0–4 years. 21–34 cases/100 000 population per year compared to only 5–17 in the other Nordic countries. Epiglottitis is more common than Hib meningitis in older children and adults. In Scandinavia the age-specific incidence of all invasive Hib infections could be estimated to be about 50–65/100 000 per year in the most susceptible age group and the risk of contracting invasive Hib disease before the age of 15 years would be about 1/200–300 children.

Acute epiglottitis--25 years experience with nasotracheal intubation, current management policy and future trends.

During a 25-year period 168 adults and 111 children in Copenhagen County were treated for acute epiglottitis. Four patients, two children and two adults died, of these the two children and one adult had a cardiac arrest on arriving at the hospital. Most children were treated by nasotracheal intubation while only some adults required nasotracheal intubation in order to secure the airway. Our data indicate that intubation of adults with epiglottitis is technically more difficult than in children. The fibrelaryngoscope, a new diagnostic tool, is advocated, and was in this study used to establish the diagnosis in 12 unclear cases of acute epiglottitis. The incidence of acute epiglottitis in children was calculated at 3.2/100,000 with a minor annual variation. As vaccination against Haemophilus influenzae type b becomes more common, the incidence will probably be markedly reduced, maybe even eradicated in children, but in adults the same reduction cannot be expected as the causative agent in this group is less frequently Haemophilus influenzae type b.