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Am J Emerg Med 2022 Jun 9. Epub 2022 Jun 9.

Department of Emergency Medicine, Brooke Army Medical Center, San Antonio, TX, United States of America. Electronic address:

Am J Emerg Med 2022 May 25. Epub 2022 May 25.

Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Electronic address:

Am J Emerg Med 2022 Jul 20;57:14-20. Epub 2022 Apr 20.

SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA. Electronic address:

Introduction: Adult epiglottitis is a serious condition that carries with it a high rate of morbidity and even mortality due to airway occlusion.

Objective: This review highlights the pearls and pitfalls of epiglottitis in adult patients, including diagnosis, initial resuscitation, and management in the emergency department (ED) based on current evidence.

Discussion: Epiglottitis is a life-threatening emergency that occurs more commonly in adults in the current medical era with vaccinations. Read More

Eur Arch Otorhinolaryngol 2022 Apr 9. Epub 2022 Apr 9.

Otorhinolaryngology Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Purpose: The purpose is to analyze the incidence of acute infectious supraglottitis in our center between 2010 and 2020, define the characteristics and trends of those patients and identify factors associated with the need of airway intervention.

Methods: A retrospective single-center observational study of a cohort of patients diagnosed with acute infectious supraglottitis between January 2010 and December 2020. Patients were stratified according to airway management. Read More

Rev Esp Anestesiol Reanim (Engl Ed) 2022 02 16;69(2):65-70. Epub 2022 Feb 16.

Department of Intensive Care, Centro Hospitalar e Universitário São João, EPE, Porto, Portugal.

Management by the environment is complex, which means a much higher percentage of difficult airways than in a regulated environment such as the operating room. Failure or prolonged attempt to tracheal intubation is associated with unfavorable outcomes and serious complications. Acute epiglottitis is a life-threatening disorder, classified as a medical emergency within the diseases of the upper respiratory airway and characterized by its sudden and deadly evolution if rapid intubation is not achieved to allow oxygenation of the patient. Read More

J Intern Med 2022 Jul 6;292(1):154-161. Epub 2022 Mar 6.

Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden.

Objective: The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS-CoV-2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID-19 patients seeking emergency care with symptoms similar to the life-threatening condition epiglottitis. Here, we present a case series and discuss management. Read More

Infect Dis (Lond) 2022 04 8;54(4):308-310. Epub 2021 Dec 8.

Faculty of Medicine, Department of Neurosurgery, Selcuk University, Konya, Turkey.

Background: In humans, coronavirus disease 2019 (COVID-19) has a variable presentation ranging from mild self-limiting respiratory tract infections to severe acute respiratory distress syndrome. Methods: We present the case of a patient who developed acute epiglottitis after surgery for an intracranial tumour and was subsequently diagnosed with COVID-19.

Results: A 58-year-old female patient developed acute-onset respiratory distress on day 6 after intracranial surgery. Read More

Ann Otol Rhinol Laryngol 2021 Nov 28:34894211051817. Epub 2021 Nov 28.

2nd Otolaryngology Department, School of Medicine, "Attikon" University Hospital, National & Kapodistrian University of Athens, Athens, Greece.

Objectives: To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE).

Methods: We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). Read More

Eur Arch Otorhinolaryngol 2022 May 22;279(5):2671-2678. Epub 2021 Nov 22.

Doncaster Royal Infirmary, Doncaster, UK.

Purpose: To report changes in adult hospital admission rates for acute ENT infections following the introduction of COVID-19-related physical interventions such as hand washing, use of face masks and social distancing of 2-m in the United Kingdom.

Methods: Retrospective cohort study comparing adult admissions with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess in the 1-year period after the introduction of COVID-related physical interventions (2020-2021) with a 1-year period before this (2019-2020) in three UK secondary care ENT departments.

Results: In total, there were significantly fewer admissions for ENT infections (n = 1073, 57. Read More

Eur Arch Otorhinolaryngol 2022 Mar 18;279(3):1425-1429. Epub 2021 Nov 18.

Departments of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 3235, 91031, Jerusalem, Israel.

Introduction: Acute supraglottitis is a potentially life-threatening condition that often necessitates intensive care unit (ICU) admission for airway monitoring. The objective of this study was to identify clinical criteria that predict a benign course for patients with acute supraglottitis.

Methods: A prospective observational study was performed. Read More

West J Emerg Med 2021 Nov 5;22(6):1326-1334. Epub 2021 Nov 5.

University of Massachusetts Medical School-Baystate, Department of Emergency Medicine, Springfield, Massachusetts.

Introduction: Adult epiglottitis is a disease process distinct from pediatric epiglottitis in microbiology, presentation, and clinical course. While traditionally considered more indolent and benign than in children, adult epiglottitis remains a cause of acute airway compromise with a mortality rate from 1-20%. Our objective was to characterize the disease course and evaluate the rate and type of airway management in this population at a tertiary, academic referral center. Read More

Clin Med (Lond) 2021 09;21(5):e539-e540

John Radcliffe Hospital, Oxford, UK

Case Presentation: A 68-year-old woman was referred for immunological investigation following an episode of meningococcal epiglottitis with associated septicaemia. Several years previously, she had been diagnosed with undifferentiated connective tissue disease. On investigation, alternative pathway complement function was normal; however, classical pathway complement activation was reduced. Read More

Am J Emerg Med 2022 Jan 7;51:427.e1-427.e2. Epub 2021 Jul 7.

Genesis Healthcare Systems, Zanesville, OH, United States of America.

There have been more than 178 million global cases of COVID-19, the disease caused by the SARS-CoV-2 virus, with more than 3.8 million deaths worldwide [1]. COVID-19 can present with a wide variety of symptoms, and one rare manifestation that has been reported in the literature is acute epiglottitis. Read More

Am J Emerg Med 2021 Nov 13;49:114-116. Epub 2021 May 13.

Department of Pediatrics, Section on Infectious Disease, United States of America. Electronic address:

Acute epiglottitis is an airway emergency presenting with edema and inflammation of the epiglottis and aryepiglottic folds [1]. Infectious and other non-infectious etiologies may cause significant airway injury presenting with similar clinical symptoms and radiographic findings [1]. While many causes of thermal epiglottitis have been described in the pediatric and young adult population, we describe an unusual case of an adolescent patient with cannabis induced thermal epiglottitis. Read More

Am J Otolaryngol 2021 Nov-Dec;42(6):103084. Epub 2021 May 19.

ENT Dept. University Hospital Waterford, Ireland.

Aims: Acute supraglottitis (AS) can be a life threatening infection that may lead to sudden airway obstruction. Thankfully, paediatric instances have decreased with public health vaccination programmes. Owing to the nature of the location of pathology, this time sensitive emergency requires astute clinical acumen and awareness of early warning signs. Read More

J Forensic Leg Med 2021 Jul 6;81:102177. Epub 2021 May 6.

Department of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.

Percutaneous tracheostomy is commonly performed in the emergency department or intensive care unit to secure the airways of patients. This procedure is associated with a low incidence of complications; however, some of them, such as iatrogenic pneumothorax, can be fatal. Pneumothorax after percutaneous tracheostomy is most often caused by perforation of the tracheal wall or malposition of the cannula. Read More

Epidemiol Infect 2021 04 29;149:e126. Epub 2021 Apr 29.

Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, SE 70182Örebro, Sweden.

Since 2015, the incidence of invasive meningococcal disease (IMD) caused by serogroup W (MenW) has increased in Sweden, due to the introduction of the 2013 strain belonging to clonal complex 11. The aim of this study was to describe the clinical presentation of MenW infections, in particular the 2013 strain, including genetic associations. Medical records of confirmed MenW IMD cases in Sweden during the years 1995-2019 (n = 113) were retrospectively reviewed and the clinical data analysed according to strain. Read More

Laryngoscope 2021 11 8;131(11):2483-2489. Epub 2021 Apr 8.

Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea.

Objectives/hypothesis: This study investigated the impacts of air pollution and meteorological factors on the occurrence of epiglottitis.

Study Design: A nested case-control study.

Methods: Participants ≥40 years old in the Korean National Health Insurance Service-Health Screening Cohort were analyzed. Read More

Am J Forensic Med Pathol 2021 Jun;42(2):164-169

From the Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.

Abstract: As of August 23, 2020, the 2019 novel coronavirus disease (COVID-19) has infected more than 23,518,340 people and caused more than 810,492 deaths worldwide including 4,717 deaths in China. We present a case of a 53-year-old woman who was admitted to the hospital because of dry coughs and high fever on January 26, 2020, in Wuhan, China. She was not tested for SARS-CoV-2 RNA until on hospital day 11 (illness day 21) because of a significant shortage of test kits at the local hospital. Read More

Biomed Phys Eng Express 2020 09 8;6(5):055003. Epub 2020 Sep 8.

Department of Otolaryngology, Head and Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, 6608550 Higashinaniwachou 2-17-77 Hyogo Prefecture, Japan.

Objective: To investigate the association between subjective pain intensity and objective parameters obtained from two autonomic function tests in a longitudinal study targeting acute pain model in otolaryngology-head and neck region: pupillary light reflex (PLR) and heart rate variability (HRV).

Approach: We enrolled 35 patients with acute otolaryngology-head and neck region inflammatory disorders at pre-treatment stage. The acute inflammatory disorders were defined as acute tonsillitis, peritonsillar abscess, acute epiglottitis, acute sinusitis, and deep neck space abscess. Read More

Am J Otolaryngol 2021 Mar-Apr;42(2):102882. Epub 2021 Jan 4.

Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.

Purpose: Evaluate trends in mortality due to acute epiglottitis before and after adoption of Haemophilus influenza Type b vaccination (Hib) in pediatric and adult populations.

Materials And Methods: Patients who died from acute epiglottis from 1979 to 2017 identified using National Vital Statistics System. Mortality rates calculated using age-adjusted US census data expressed in rate per 100,000 individuals. Read More

Head Neck Pathol 2021 Sep 28;15(3):1074-1081. Epub 2020 Dec 28.

Vanderbilt University Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S. Suite 7209, Nashville, TN, 37232, USA.

Supraglottitis is a life-threatening, predominantly bacterial disease that is rarely caused by viral etiologies. Herpes Simplex Virus (HSV) supraglottitis has been infrequently reported, but its presentation can mimic that of bacterial supraglottitis or pharyngitis which may lead to delayed diagnosis and increased morbidity. We present a case of supraglottitis in an immunocompetent man initially thought to have bacterial epiglottitis. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 Oct 24;138(5):329-332. Epub 2020 Dec 24.

Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire d'Angers, 4, Rue Larrey, 49100 Angers, France; Équipe MitoLab, UMR CNRS 6015, U1083 INSERM, Institut MitoVasc, SFR ICAT, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Bâtiment IRIS/IBS, Rue des Capucins, 49933 Angers cedex 9, France.

Objectives: To identify contributive criteria in decision-making for intubation in acute epiglottitis, based on clinical and endoscopic data in adult patients, and to study clinical and biological characteristics and management.

Materials And Methods: Diagnosis was established by flexible endoscopy showing epiglottic edema in association with general signs of sepsis in 28 patients consulting into two French hospitals between 2005 and 2016. Retrospective univariate and multivariate analysis between patients managed by intubation (Group I) or surveillance (Group S) was performed on clinical and endoscopic data. Read More

Int J Pediatr Otorhinolaryngol 2020 Nov 24;138:110385. Epub 2020 Sep 24.

Department of Ophthalmology and Otolaryngology - Head and Neck Surgery, Université Laval, Quebec City, Quebec, Canada.

Necrotizing epiglottitis (NE) is a rare but extremely serious variant of acute bacterial epiglottitis. So far, it has been reported mostly in immunocompromised adults and only seldomly in the pediatric population. We describe the case of a 15-month-old immunocompetent child who presented to our tertiary referral center with necrotizing epiglottitis. Read More

BMJ Open 2020 11 3;10(11):e038683. Epub 2020 Nov 3.

Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Puzi, Taiwan

Objectives: Patients with uremia are prone to infection; however, end-stage renal disease (ESRD) as a risk factor for acute epiglottitis warrants study. We investigated the risk of severe epiglottitis requiring hospitalisation in patients with ESRD.

Setting: We conducted a retrospective matched cohort study by using the claims data of Taiwan's National Health Insurance Research Database. Read More

Am J Otolaryngol 2021 Mar-Apr;42(2):102779. Epub 2020 Oct 22.

Department of Otolaryngology, Juntendo University School of Medicine, Japan.

Purpose: Upper airway stenosis is one of the most formidable situations in medicine and is frequently encountered in the ENT clinic. We introduce here our method of emergency endonasal endotracheal intubation under videoendoscopic observation.

Methods: Transnasal endoscopic observation was done, and the region of airway stenosis was detected. Read More

Tidsskr Nor Laegeforen 2020 09 11;140(13). Epub 2020 Sep 11.

Background: Acute epiglottitis in adults is a rare, potentially life-threatening condition caused by a bacterial infection in the epiglottis. Typical symptoms are fever, sore throat, and respiratory distress caused by upper airway obstruction. Proper treatment is needed for a good outcome. Read More

Cureus 2020 Aug 23;12(8):e9976. Epub 2020 Aug 23.

Infectious Diseases, Hamad Medical Corporation, Doha, QAT.

Introduction Acute adult supraglottitis (AAS) is one of the upper airway infections that can potentially cause upper airway obstruction and, if not treated promptly, can be life-threatening. The widespread use of vaccines against has decreased the incidence of epiglottitis in children, whereas the incidence of AAS is on the rise. We aim to highlight the presentation, diagnosis, and management in AAS with our study. Read More

Clin Infect Dis 2021 05;72(10):1850-1853

Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.

George Washington's medical history has been recounted so many times and with such consistency that it seems that nothing new remains to be said about the panoply of disorders that plagued him during his life. The same can be said for the particular one that carried him off at age 67. We know that he had small pox, dysentery, recurrent attacks of malaria, and a host of other infections during his long and spectacularly productive career. Read More

Laryngoscope 2021 01 21;131(1):E133. Epub 2020 Jul 21.

Department of Otolaryngology/Head and Neck Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.