Pediatrics Epiglottitis Publications (128)


Pediatrics Epiglottitis Publications

Hosp Pediatr
Hosp Pediatr 2017 Jan;7(1):54-56
Department of Pediatrics and Communicable Diseases, The University of Michigan Medical School, C.S. Mott Children's Hospital, Ann Arbor, Michigan
Korean J Pediatr
Korean J Pediatr 2015 Oct 21;58(10):380-5. Epub 2015 Oct 21.
Department of Pediatrics, National Medical Center, Seoul, Korea.

Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. Read More

We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients.
The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged ≤18 years presenting with croup or epiglottitis.
We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were 2.2±2.0 and 5.6±5.8 years, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05).
Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

Indian J Pediatr
Indian J Pediatr 2015 Aug 25;82(8):737-44. Epub 2015 Jun 25.
Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Children with upper airway obstruction are both unique and variable in their presentation and management, often posing a challenge to the pediatrician. Several anatomical and physiologic peculiarities make a child vulnerable to develop an obstruction of upper airways. The characteristic finding in upper airway obstruction is stridor-inspiratory, biphasic or expiratory. Read More

The etiologies vary widely throughout the age groups and according to the mode of presentation. The approach starts with suspicion, mandates careful clinical evaluation of the degree of obstruction and many a times emergency measures precede any investigation or even precise diagnosis. Maintaining an open and stable airway is of the utmost importance, often requiring a team approach of emergency physician, pediatrician, otorhinolaryngologist and pediatric pulmonologist. The commonest condition presenting with upper airway obstruction in pediatric population is viral croup. Croup is a clinical diagnosis in a febrile child, with barking cough and stridor preceded by upper respiratory infection. It is treated with systemic or inhaled steroids and nebulized epinephrine. Epiglottitis and bacterial tracheitis are acute bacterial infections of upper airways, presenting as true airway emergencies. Though the mainstay of therapy is IV antibiotics, the prime concern is maintenance of airway, which frequently requires endotracheal intubation. Rigid bronchoscopy is the procedure of choice for airway foreign bodies, a common cause of upper airway obstruction in children below 3 y of age. Airway malacias are the commonest cause of chronic stridor and are mostly managed conservatively.

J. Korean Med. Sci.
J Korean Med Sci 2015 May 15;30(5):617-24. Epub 2015 Apr 15.
Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Korea. ; Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Korea.

This study was conducted to estimate the prevalence of antimicrobial prescribing for acute upper respiratory tract infections (URI) among pediatric outpatients and to identify the national patterns of its use from 2009 to 2011 in Korea. Using National Patients Sample database from 2009 to 2011, we estimated the frequency of antibiotics prescribing for URI in pediatric outpatients with diagnoses of acute nasopharyngitis (common cold), acute sinusitis, acute pharyngitis, acute tonsillitis, acute laryngitis/tracheitis, acute obstructive laryngitis/epiglottitis, and acute upper respiratory infections of multiple and unspecified sites. The proportions of each antibiotic class were calculated by year and absolute and relative differences were estimated. Read More

Also, we investigated daily amount of prescribed antibiotics per defined population according to the type of medical care institution, physician specialty, and geographic region. The overall antibiotic prescribing proportion was 58.7% and its annual proportion slightly decreased (55.4% in 2011 vs. 60.5% in 2009; adjusted odds ratio, 0.82; 95% confidence interval, 0.82-0.83). Variations by the type of medical care institution were observed. Tertiary hospitals (45.0%) were less likely to prescribe antibiotics than primary care clinics (59.4%), hospitals (59.0%), and general hospitals (61.2%); they showed different tendencies in choosing antibiotics. Variations by physician specialty and region were also observed. Prevalence of antimicrobial prescribing for pediatric URI is still considered higher than that of western countries and varies by the type of medical care institution, physician specialty, and geographic region.

Respirol Case Rep
Respirol Case Rep 2014 Sep 25;2(3):116-9. Epub 2014 Aug 25.
Department of Pediatrics, University of Toledo Toledo, Ohio, United States of America.

We report an unusual case of a neonate with aphonia due to epiglottitis with a concomitant methicillin-resistant S taphylococcus aureus (MRSA) infection of the genitalia and associated septic emboli to the groin area and mouth. We postulate that the MRSA infection caused a transient bacteremia that seeded the epiglottis, likely causing the epiglottitis. In the evaluation of a neonate with aphonia, while the two primary differentials to consider are vocal cord paralysis and laryngeal web, among other considerations is epiglottitis (supraglottitis). Read More

Arch Pediatr
Arch Pediatr 2015 Jun 2;22(6):613-5. Epub 2014 Oct 2.
Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.

Acute epiglottitis has become an exceptional observation in pediatrics. The introduction of Haemophilus influenzae type B vaccine changed the morbidity, mortality, and microbiology of this disease. We report the case of an 11-month-old infant with acute epiglottitis due to group A β-hemolytic streptococcus. Read More

Pediatr Emerg Care
Pediatr Emerg Care 2014 Oct;30(10):733-5
From the *Department of Medicine, University of Toronto, Toronto, Canada; †Department of Pediatrics, Albert Einstein University, New York, NY; ‡Pediatric Emergency Medicine, St. Barnabas Hospital, Bronx, NY; §Division of Pediatric Otolaryngology-Head and Neck Surgery, B.C. Children's Hospital; and ∥Division of Pediatric Emergency Medicine, Department of Pediatrics, Wilson Centre for Research In Education, Centre for Faculty Development, Hospital for Sick Children, University of Toronto, Toronto, Canada.

Epiglottitis is a life-threatening entity that can present in children or adults. Although the incidence has declined since the introduction of the Haemophilus influenzae type B vaccine in 1985, cases continue to be identified in high-risk populations. In pediatric oncology patients specifically, epiglottitis has been reported after initiation of chemotherapy. Read More

We report the first case of epiglottits as the initial presentation of leukemia in a pediatric patient.

BMJ Clin Evid
BMJ Clin Evid 2014 Sep 29;2014. Epub 2014 Sep 29.
Department of Pediatrics, University of Calgary, Calgary, Canada.

Croup is characterised by the abrupt onset, most commonly at night, of a barking cough, inspiratory stridor, hoarseness, and respiratory distress due to upper airway obstruction. It leads to signs of upper airway obstruction, and must be differentiated from acute epiglottitis, bacterial tracheitis, or an inhaled foreign body. Croup affects about 3% of children per year, usually between the ages of 6 months and 3 years, and 75% of infections are caused by parainfluenza virus. Read More

Symptoms usually resolve within 48 hours, but severe upper airway obstruction can, rarely, lead to respiratory failure and arrest.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in children with mild croup and moderate to severe croup? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 19 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: corticosteroids (dexamethasone, intramuscular and oral), nebulised budesonide, oral prednisolone, heliox, humidification, and nebulised adrenaline (racemate and L-adrenaline [ephinephrine]).

Paediatr Anaesth
Paediatr Anaesth 2014 Jul 2;24(7):717-23. Epub 2014 Apr 2.
Departments of Neurology and Anesthesiology, Perioperative and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.

Paralytic poliomyelitis, Reye syndrome, Hemophilus Influenzae type B epiglottitis, bacterial meningitis, and meningococcal septic shock are catastrophic illnesses that in the last 60 years have shaped the development of pediatric intensive care. Neurocritical care has been at the forefront of our thinking and, more latterly, as a specialty we have had the technology and means to develop this focus, educate the next generation and show that outcomes can be improved-first in adult critical care and now the task is to translate these benefits to critically ill children. In our future we will need to advance interventions in patient care with clinical trials. Read More

MeSH terms: Neurocritical care; child; traumatic brain injury; status epilepticus; cerebrovascular.