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Cureus 2018 Oct 22;10(10):e3475. Epub 2018 Oct 22.

Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.

The authors report a case of a 69-year-old female with difficulty swallowing and neck swelling and review the clinical presentation, radiographic features and treatment of adult epiglottitis. Epiglottitis remains a medical emergency, with the potential for airway compromise. The authors present this case because it is a potentially life-threatening infection that warrants prompt diagnosis and management. Read More

Laryngoscope 2018 Dec 24. Epub 2018 Dec 24.

Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, Yale-New Haven Hospital, Yale Cancer Center, New Haven, Connecticut, U.S.A.

Objectives: To characterize trends of adult epiglottitis presenting to the emergency department (ED) and analyze mortality.

Methods: We utilized the National Emergency Department Sample to characterize adult epiglottitis from 2007 to 2014 and used provided weights to obtain nationally representative data (all presented data are weighted). Univariate and multivariate analyses were conducted to determine predictors of mortality. Read More

IDCases 2018 13;14:e00466. Epub 2018 Nov 13.

Department of Pharmacy, UCHealth Medical Center of the Rockies, Loveland, CO, USA.

Clin Pract Cases Emerg Med 2018 Nov 16;2(4):338-340. Epub 2018 Oct 16.

St. Lucie Medical Center, Department of Emergency Medicine, Port St. Lucie, Florida.

Historically epiglottitis has been considered a childhood disease. However, the introduction of the type B vaccine has decreased the incidence of epiglottitis in children. It is important to recognize modern epiglottitis as a disease of adults. Read More

J Emerg Med 2018 Dec 17;55(6):841-844. Epub 2018 Oct 17.

University of California San Diego, San Diego, California.

Background: In the winter months, one often sees a large increase in the volume of patients presenting to emergency departments with acute pharyngitis. While most cases of acute pharyngitis are benign, a rare minority can be life threatening.

Case Report: We report a case of epiglottis with a concomitant peritonsillar abscess (PTA) in an adult who presented to the emergency department with a sore throat. Read More

Medicine (Baltimore) 2018 Sep;97(37):e12256

Department of Emergency Medicine.

Lateral neck radiography is often used as a screening tool in emergency departments for suspected acute epiglottitis. The qualitative radiographic signs have been mainly used. The aim of this study was to evaluate the accuracy of objective radiographic parameters to aid diagnosis of acute epiglottitis. Read More

ANZ J Surg 2018 Nov 11;88(11):1135-1140. Epub 2018 Sep 11.

Department of Ear Nose and Throat/Head and Neck Surgery, Austin Health, Melbourne, Victoria, Australia.

Background: This study reviewed the demographics, presentation, management, complications and outcomes of acute epiglottitis post Haemophilus influenzae type-b vaccine introduction in Australia.

Methods: Retrospective review of acute epiglottitis at four Victorian tertiary centres from 2011 to 2016 was conducted. Patient characteristics, presentation, investigations, management, complications and outcomes were recorded. Read More

Am J Otolaryngol 2018 Nov - Dec;39(6):785-787. Epub 2018 Jul 25.

Department of Otolaryngology, MetroHealth Medical Center, 2500 Metrohealth Dr, Cleveland, OH 44109, United States of America. Electronic address:

Objective: Necrotizing supraglottitis is a rare but potentially morbid infection most often seen in immunocompromised patients. All reported cases have utilized intravenous antibiotic therapy as the mainstay of treatment and many have had associated morbidities.

Methods: We describe a case of a 50-year-old previously healthy female who presented with necrotizing epiglottis and was treated with immediate surgical debridement followed by directed antibiotic therapy. Read More

PLoS One 2018 11;13(6):e0199036. Epub 2018 Jun 11.

Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Objective: Studies have revealed that 3.5%-26.6% of patients with epiglottitis have comorbid diabetes mellitus (DM). Read More

BMJ Case Rep 2018 May 26;2018. Epub 2018 May 26.

Institute of Primary Care, University of Zurich, Zurich, Switzerland.

A 78-year-old female patient presented to our emergency department with a 5-day history of throat pain, hoarseness and a progressive and dolorous submandibular swelling. Due to non-conclusive clinical examination and the stable but visibly affected patient, we performed a neck CT scan with intravenous contrast, which showed the thumbprint sign typical for acute epiglottitis. Within minutes, the patient's condition deteriorated and the patient was close to respiratory exhaustion. Read More

Emerg Med Australas 2018 08 23;30(4):591-592. Epub 2018 May 23.

School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

J Emerg Med 2018 05 6;54(5):619-629. Epub 2018 Mar 6.

Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Pharyngitis is a common disease in the emergency department (ED). Despite a relatively low incidence of complications, there are many dangerous conditions that can mimic this disease and are essential for the emergency physician to consider.

Objective: This article provides a review of the evaluation and management of group A β-hemolytic Streptococcal (GABHS) pharyngitis, as well as important medical conditions that can mimic this disease. Read More

BMJ Case Rep 2018 Mar 7;2018. Epub 2018 Mar 7.

Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Lyon, France.

Medicine (Baltimore) 2018 Feb;97(7):e9941

Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan.

Rationale: Acute epiglottitis is a potentially life-threaten disease, which makes it more challenging to save the life for doctors. Unexpected deaths in custody are a primary cause of concern for the forensic community and doctor worldwide.

Patient Concerns: We present a case of a 44-year-old male detainee who was clinically suspected of dying of acute epiglottitis. Read More

Chin Med J (Engl) 2018 Jan;131(1):109-110

Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China.

Semergen 2018 May - Jun;44(4):283-285. Epub 2017 Nov 20.

Servicio Otorrinolaringología, Hospital de Jarrio, Coaña, Asturias, España.

Braz J Otorhinolaryngol 2017 Oct 5. Epub 2017 Oct 5.

Wakayama Medical University, Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama, Japan. Electronic address:

CMAJ 2017 10;189(41):E1289

Mitoyo General Hospital, Himehama, Toyohama-cho, Kanonji-city, Kagawa, Japan.

A A Pract 2018 Feb;10(4):73-75

From the University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to successfully manage acute adult epiglottitis with rapidly progressing airway obstruction. Read More

Acta Otolaryngol 2018 Jan 21;138(1):60-65. Epub 2017 Aug 21.

a Department of Otorhinolaryngology, Head and Neck Surgery , Aarhus University Hospital , Aarhus , Denmark.

Introduction: The significant pathogens in acute epiglottitis (AE) are poorly defined in the post Haemophilus influenza type b-vaccine era. Furthermore, there is a lack of clinical evaluations of antibiotic regimens in patients with AE. We aimed to evaluate the effectiveness of empiric intravenous ampicillin in the treatment of patients with AE. Read More

N Z Med J 2017 07 21;130(1459):71-72. Epub 2017 Jul 21.

Junior Resident in Radiology, Dept of Radiology, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Pondicherry 607402, India.

Otolaryngol Head Neck Surg 2017 12 11;157(6):928-939. Epub 2017 Jul 11.

1 Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.

Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Read More

BMJ Case Rep 2017 Jun 18;2017. Epub 2017 Jun 18.

Otorhinolaryngology, Head and Neck Surgery, Royal Derby Hospital, Derby, UK.

Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the type B vaccination and is more recently caused by , , non-type B, , and Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. Read More

Laryngoscope 2017 09 11;127(9):2106-2112. Epub 2017 May 11.

Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University of Jerusalem, Israel.

Objectives/hypothesis: Acute supraglottitis is a potentially life-threatening condition due to rapid onset upper airway obstruction. The study aimed to characterize adult acute supraglottitis patients and to recognize factors associated with an aggressive disease course.

Study Design: Retrospective chart review. Read More

J Voice 2018 Jan 4;32(1):101-103. Epub 2017 May 4.

Department of Otolaryngology Head and Neck Surgery and Maxillo-Facial Surgery. Electronic address:

Mucous membranous pemphigoid (MMP) is an autoimmune disease of the mucous membranes characterized by formation of subepithelial blisters. MMP commonly involves the ocular and oral mucosa. Laryngeal MMP is very rare, estimated as occurring in 1 of 10 million persons in the general population. Read More

Am J Emerg Med 2017 Oct 20;35(10):1519-1524. Epub 2017 Apr 20.

Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.

Objectives: To retrospectively evaluate the diagnostic performance of qualitative and quantitative radiographic parameters for diagnosing adult acute epiglottitis, and identify the prevalence and risk factors of false-negative neck radiography-based diagnosis of acute epiglottitis.

Methods: An emergency physician and a radiologist independently reviewed neck radiographs of 91 patients with laryngoscopy-confirmed acute epiglottitis and 91 control subjects between March 2010 and June 2016 for qualitative and quantitative radiographic parameters of acute epiglottitis, and concluded a diagnosis. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic performance of radiographic parameters, while independent risk factors of false-negative diagnosis were determined by multivariate logistic regression analysis. Read More

Clin Infect Dis 2017 Jun;64(11):1626-1628

Department of Infectious Diseases, Istituto Superiore di Sanità, Rome.

We report on the first detection of 2 cases of invasive Haemophilus influenzae type a (Hia) disease in Italy. The cases were sustained by the same Hia "strain" belonging to the ST23 clone that has previously been reported only outside Europe. The emergence of invasive Hia disease is of concern. Read More

Perm J 2017 ;21

Emergency Physician at the Santa Clara Medical Center in CA.

Introduction: Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis. Read More

Am J Case Rep 2016 Nov 8;17:834-836. Epub 2016 Nov 8.

Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.

BACKGROUND Despite a shift in the epidemiology of epiglottitis following the introduction of the Haemophilus influenzae type B vaccine, acute infectious epiglottitis continues to be a relatively common and potentially life-threatening infection in adults. Epiglottitis complicated by abscess is rare, and emphysematous abscess is even less common. Early diagnosis and intervention is paramount in reducing morbidity and mortality. Read More

Cleve Clin J Med 2016 Oct;83(10):712-714

Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.

Am J Forensic Med Pathol 2016 Dec;37(4):275-278

From the Ontario Forensic Pathology Service; and Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada.

We report a retrospective review of fatal acute epiglottitis cases in adults in the province of Ontario, Canada, between 2001 and 2014. Information on demographics, clinical history, gross, microscopic, and laboratory findings were collected and analyzed. Eleven cases, predominantly male (73%), with a mean age of 50 years were identified. Read More

JAMA Otolaryngol Head Neck Surg 2016 12;142(12):1243-1244

Department of Ear, Nose, and Throat, General Hospital "G. Gennimatas," Thessaloniki, Greece.

Am J Emerg Med 2016 Dec 14;34(12):2467.e3-2467.e4. Epub 2016 Jun 14.

Department of Neurosurgery, Fujita Health University Hospital, Toyoake, Japan.

BMJ Case Rep 2016 May 31;2016. Epub 2016 May 31.

Department of Otorhinolaryngology, Head and Neck Surgery, Mitoyo General Hospital, Kannonji, Kagawa, Japan.

J Emerg Nurs 2017 05 7;43(3):266-267. Epub 2016 Apr 7.

Washington, DC; Murfreesboro, TN; Dallas and Waco, TX.

Euro Surveill 2016 ;21(12)

Immunisation Department, Public Health England, London United Kingdom.

Atypical clinical presentations associated with group W meningococcal disease (MenW) are well-described and include pneumonia, septic arthritis, endocarditis and epiglottitis/supraglottitis. Following anecdotal reports of teenagers presenting with predominantly gastrointestinal symptoms, we undertook a case review of MenW cases in 15 to 19 year-olds diagnosed in England between July 2015 and January 2016. Of the 15 cases, seven presented with a short history of nausea, vomiting and diarrhoea; five of these seven cases died within 24 hours of presentation to hospital. Read More

Ugeskr Laeger 2016 02;178(6):V66984

Nihon Jibiinkoka Gakkai Kaiho 2015 Nov;118(11):1301-8

We carried out a retrospective review of 285 cases of acute epiglottitis (180 males, 105 females, mean age 49.6 years) that required inpatients hospital care between 1998 and 2014. All the patients complained of sore throat, and 62 patients complained of respiratory discomfort; 17 patients had severe dyspnea, and 27 patients required airway management (tracheotomy in 25, cricothyroidotomy in 2 patients). Read More

B-ENT 2016;12(4):279-284

Airway intervention in cases of acute epiglottitis.Problem/objectives: In cases of acute epiglottitis, indications for airway intervention have not been established. In the present study, we reviewed patients with acute epiglottitis to identify clinical factors, which suggest airway intervention should be performed. Read More

Eur J Clin Pharmacol 2016 Mar 26;72(3):359-64. Epub 2015 Dec 26.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Rd., Haidian district, Beijing, 100191, People's Republic of China.

Purpose: The purpose of this study was to describe the prescription of antibacterial agents for acute upper respiratory tract infections (URIs) in Beijing.

Methods: A total of 8,588,699 outpatient cases in tertiary hospitals with acute upper respiratory tract infections (URIs) were selected from the Beijing Medical Claim Data for Employees (BMCDE) from Oct 2010 to Sep 2012. Second-generation cephalosporins, third-generation cephalosporins, fourth-generation cephalosporins, fluoroquinolones, macrolides (except for erythromycin), combinations of penicillins (including β-lactamase inhibitors), and streptomycins were classified as broad-spectrum antibacterial agents. Read More

J Emerg Med 2016 Jan 10;50(1):194-7. Epub 2015 Oct 10.

Department of Emergency Medicine, Temple University, Philadelphia, Pennsylvania.

Background: At our institution, there were a number of adverse patient events related to an unstable airway that led to the formation of a designated critical airway response team (CAT). It was hoped that this would improve patient outcomes in such matters.

Objective: Our aim was to evaluate the impact of the creation of the CAT. Read More

Ned Tijdschr Geneeskd 2015 ;159:A9061

Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht.

Epiglottitis is a rare and life-threatening cause of acute sore throat. Usually, epiglottitis is caused by a bacterium, such as Haemophilus influenzae type b. Symptoms of epiglottitis are acute and rapidly progressive sore throat, a hoarse voice, fever, and drooling. Read More

Ear Nose Throat J 2015 Jul;94(7):E5-7

Department of Otolaryngology, 5A ENT Clinic, Royal Hobart Hospital, 48 Liverpool St., Hobart 7000, Tasmania, Australia.

Cervical necrotizing fasciitis secondary to epiglottitis is rare. The standard treatment of this severe condition has long been early and aggressive surgical debridement and adequate antimicrobial therapy. We report the case of an immunocompetent 59-year-old man who developed cervical necrotizing fasciitis as a complication of acute epiglottitis. Read More

Br J Dermatol 2015 Oct 15;173(4):930-9. Epub 2015 Oct 15.

Merck & Co., Inc., Kenilworth, NJ, U.S.A.

Background: Tildrakizumab is a high-affinity, humanized, IgG1/κ, anti-interleukin (IL)-23p19 monoclonal antibody that does not bind human IL-12 or p40 is being developed for the treatment of chronic plaque psoriasis.

Objectives: To evaluate the safety and efficacy of subcutaneous tildrakizumab in patients with moderate-to-severe chronic plaque psoriasis.

Methods: A three-part, randomized, double-blind, phase IIb trial was conducted in 355 adults with chronic plaque psoriasis. Read More

Auris Nasus Larynx 2015 Dec 27;42(6):501-4. Epub 2015 May 27.

Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu, Japan.

Invasive aspergillosis is a life-threatening infection in immunocompromised hosts and occurs most frequently in the lungs. Invasive laryngeal aspergillosis is extremely rare. Due to the potential progression of invasive aspergillosis, antifungal therapy must be started immediately in cases involving clinical suspicion of the disease. Read More

PLoS One 2015 6;10(5):e0125736. Epub 2015 May 6.

Service de Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.

Background: Acute epiglottitis is a potentially life threatening disease, with a growing incidence in the adult population. Its long-term outcome after Intensive Care Unit (ICU) hospitalization has rarely been studied.

Methodology And Principal Findings: Thirty-four adult patients admitted for acute epiglottitis were included in this retrospective multicentric study. Read More

Otolaryngol Head Neck Surg 2015 Jul 30;153(1):48-53. Epub 2015 Apr 30.

Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea

Objective/hypothesis: To evaluate the efficacy of spinal needle aspiration for symptom improvement in awake patients with epiglottic abscess (EA).

Study Design: Prospective randomized controlled study.

Setting: Tertiary center. Read More

N Engl J Med 2015 Apr;372(15):e20

Sinai Hospital of Baltimore, Baltimore, MD

Turk Arch Otorhinolaryngol 2015 Mar 1;53(1):10-14. Epub 2015 Mar 1.

Department of Otorhinolaryngology, Fırat University Faculty of Medicine, Elazığ, Turkey.

Objective: The present study reports the etiological differences, clinical features, management, and patient outcomes between infectious and noninfectious causes of epiglottitis in adult patients.

Methods: The medical records of 24 patients with infectious and noninfectious epiglottitis were investigated. Diagnosis was made by anamnesis and endoscopic examination. Read More

A A Case Rep 2014 Mar;2(5):55-6

From the *City Hospital, Birmingham; and †the Department of Anaesthesia, Barnet and Chase Farm Hospital, London, United Kingdom.

Acute adult epiglottitis is a rare and potentially fatal upper airway condition, requiring prompt recognition, resuscitation, stabilization, and transfer to definitive care. Treatment centers on skilled airway management and early antimicrobial therapy. We describe a patient with acute adult epiglottitis in whom airway management using noninvasive positive pressure ventilation was successful allowing avoidance of tracheal intubation. Read More