Epiglottitis, Adult

Epiglottitis, Adult is a topic covered in the 5-Minute Emergency Consult.

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  • Rapidly progressive inflammation of the epiglottis and surrounding tissues leading to airway compromise
  • May be more indolent in adults than pediatrics; rapid progression to total airway occlusion still seen in adults
  • Although the incidence of pediatric epiglottitis has been decreasing, the incidence in adults is increasing
  • Inflammation of supraglottic structures:
    • Epiglottis:
      • Edema is the primary airway concern
      • May be primary or secondary from adjacent structures
    • Vallecula
    • Arytenoids
  • Incidence is 1–4:100,000 adults per year and rising
  • More common in men: 3:1
  • Adult mortality rate is 7% (<1% in children)
  • Most common in 5th decade of life
  • Immunocompromised patients may be particularly fulminant, with minimally associated symptoms and unusual pathogens, such as Candida and Pseudomonas aeruginosa
  • Complications:
    • Total airway obstruction
    • Retropharyngeal abscess
    • Acute respiratory distress syndrome
    • Pneumonia
    • Empyema


  • Infectious causes:
    • Haemophilus influenzae B, also type A and nontypeable strains
    • Haemophilus parainfluenzae
    • Streptococcus pneumoniae
    • Staphylococcus aureus
    • Group A Streptococcus
    • Neisseria meningitis
    • Herpes simplex
    • Cytomegalovirus
    • P. aeruginosa
    • Numerous other uncommon agents
  • Physical agents:
    • Chemical and thermal burns
    • Toxic or illicit drug inhalation
  • Trauma, instrumentation

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