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BMC Infect Dis 2020 May 13;20(1):340. Epub 2020 May 13.

Department of Global Public Health, Health Systems and Policy. Karolinska Institutet, SE-171 77, Stockholm, Sweden.

Background: Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital, as typical hospitals of low- and middle-income countries, and to compare antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended. Read More

Cureus 2020 Jan 25;12(1):e6771. Epub 2020 Jan 25.

Anesthesiology, University of Florida College of Medicine, Jacksonville, USA.

Awake intubation is frequently described in the literature as the preferred method for securing the airway in adult patients with epiglottitis, whereas children with epiglottitis are usually intubated following an inhalational induction. However, if topicalization is difficult due to the presence of an abscess or an uncooperative patient, an inhalational induction may still be a reasonable approach in the adult patient. In a review of the literature, only one recent case report had been found describing an inhalational induction with video laryngoscopy. Read More

Case Rep Infect Dis 2019 12;2019:9674852. Epub 2019 Dec 12.

Bahrain Defence Force Royal Medical Services, Riffa, Bahrain.

An epiglottic abscess is a rare complication of acute epiglottitis and is life threatening. We describe a case report of a diabetic adult male, who presented with an epiglottic abscess. Culture results showed , n organism rarely reported as a cause of acute epiglottitis. Read More

Eur Arch Otorhinolaryngol 2019 Nov 5;276(11):3173-3177. Epub 2019 Sep 5.

Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, PO Box 263, 00029 HUS, Helsinki, Finland.

Purpose: In acute epiglottitis (AE) or acute supraglottitis (AS), the management of the airway is crucial. We hypothesized that tracheotomized patients recover faster than intubated patients do.

Methods: We retrospectively reviewed all adult AE and AS patients, who underwent intubation or tracheotomy between 2007 and 2018 in a tertiary care center. Read More

Laryngoscope 2020 May 30;130(5):E357. Epub 2019 Aug 30.

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

Laryngoscope 2020 May 30;130(5):E298. Epub 2019 Aug 30.

Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.

N Engl J Med 2019 Aug;381(9):e15

Vanderbilt University Medical Center, Nashville, TN

Forensic Sci Med Pathol 2020 Mar 29;16(1):177-179. Epub 2019 Jul 29.

Western Michigan University Homer Stryker MD School of Medicine, 300 Portage St, Kalamazoo, MI, 49008, USA.

Although death due to epiglottitis is well-reported in the medical literature, because of vaccines and antibiotics, deaths caused by epiglottitis are rare in the era of modern medicine. This report presents a case of epiglottitis-related death occurring in a middle-aged diabetic man. He initially presented to an emergency department with complaints of a sore throat and bilateral ear pain. Read More

Laryngoscope 2020 Feb 7;130(2):465-473. Epub 2019 Jun 7.

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

Objective: Epiglottitis is typically considered a pediatric disease; however, there is growing evidence that the incidence of adult epiglottitis has changed since the introduction of the Haemophilus influenzae vaccine. The literature is composed of multiple small series with differing findings. To date, there has been no attempt to collaborate evidence on predictors of airway intervention in this disease. Read More

Harefuah 2019 May;158(5):285-287

Internal Department C, Sheba Medical Center, Israel.

Introduction: Acute epiglottitis/supraglottitis is an acute disease with potential life-threatening complications such as airway obstruction. We present the case of an 85 year old woman hospitalized due to pain in her neck, odynophagia and unclear speech. Bacteraemia with Neisseria meningitidis type Y was detected. Read More

Ann Otol Rhinol Laryngol 2019 Jun;128(6_suppl):111S-116S

1 Department of Otorhinolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Objectives: The aim of this study was to clarify the role of serum phosphorylcholine (PC)-specific immunoglobulin M (IgM) as a natural antibody against infectious diseases.

Methods: The relationship between serum PC-specific IgM level and C-reactive protein level or white blood cell counts was examined in patients with severe upper respiratory tract infections (ie, acute epiglottitis and peritonsillar abscess).

Results: PC-specific IgM level was significantly negatively correlated with C-reactive protein level and white blood cell count. Read More

Ann Emerg Med 2019 05;73(5):e73-e74

Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Cleve Clin J Med 2019 Mar;86(3):161-162

Infectious Disease Division, NYU Winthrop Hospital, Mineola, NY, USA.

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 2019 05 24;129(5):1107-1112. 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

J Clin Anesth 2019 05 10;54:143-144. Epub 2018 Dec 10.

Department of Anesthesiology, Osaka Medical College, Japan.

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 11 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 ;21:16-089

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

Age Ageing 2017 05;46(3):531

Airedale General Hospital, Keighley BD20 6TD, UK.

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.