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Epiglottitis, Adult

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

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Basics

Description

  • 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

Etiology

  • 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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Citation

Rosen, Peter, et al., editors. "Epiglottitis, Adult." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307490/all/Epiglottitis__Adult.
Epiglottitis, Adult. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307490/all/Epiglottitis__Adult. Accessed April 25, 2019.
Epiglottitis, Adult. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307490/all/Epiglottitis__Adult
Epiglottitis, Adult [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307490/all/Epiglottitis__Adult.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Epiglottitis, Adult ID - 307490 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307490/all/Epiglottitis__Adult PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -