Case and literature review: adult acute epiglottitis – rising incidence or increasing awareness?

Objective: The prevalence of adult acute epiglottitis is probably more common than is generally appreciated. A retrospective case review in a district hospital and a medical literature search may provide baseline information to guide future strategies. Methods: Cases of acute epiglottitis in a period of 3 years and 4 months were traced from the hospital computer systems. Medical records were reviewed. Medical literature on "adult acute epiglottitis" was searched through Medline and EMBASE. Relevant full text articles were retrieved through hospital library network. Results: From February 1998 to June 2001, 11 cases of acute epiglottitis were identified. The age range was 34-78 (mean 47.5, median 41). There was no paediatric case. The male to female ratio was 9:2. Eight presented with fever, sore throat and dysphagia, one presented with dyspnoea and two presented as foreign body in throat. Nine were treated successfully conservatively. Two were intubated prophylactically. There was no case fatality. Conclusion: Adult acute epiglottitis has become much commoner than its paediatric counterpart. Acute epiglottitis should be suspected in all patients with a sore throat and dysphagia, especially if symptoms are out of proportion to the pharyngeal inflammation. (Hong Kong j.emerg.med. 2001;8:227-231)