Adult epiglottitis Heightened awareness saves livesBMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6930.719 (Published 12 March 1994) Cite this as: BMJ 1994;308:719
- W H Konarzewski
EDITOR, - M J Stuart and T J Hodgetts draw attention to the fact that epiglottitis is just as life threatening in adults as in children.1 I am aware of two adults who died of epiglottitis in the past seven years. Both presented with severe sore throats but no symptoms of upper airway obstruction until sudden and fatal occlusion of their airways. One had been discharged home and the other was in hospital.
Stuart and Hodgetts also point out that cricothyrotomy may be lifesaving. This is illustrated by a third case. A 20 year old man presented with a sore throat and stridor, which worsened rapidly as he was transferred from the casualty department to the intensive therapy unit. Cricothyrotomy was performed urgently with a Mini-Trach (Portex). His symptoms were rapidly relieved, and oxygenation was improved by passing 6 litres of oxygen/minute down the Mini-Trach tube by an 8 gauge suction catheter. Subsequently he underwent uneventful general anaesthesia and a formal tracheostomy.
Adult epiglottitis is serious but curable. Hopefully, with increased awareness of its presentation and treatment, it will claim fewer lives.
Causative organism may be elusive
- J Raphael
EDITOR, - M J Stuart and T J Hodgetts recommend that antibiotics effective against Haemophilus influenzae should be given to adults with epiglottitis.1 I take issue with this. Although the recommendation is reasonable for the disease in children, which is almost always due to this microorganism, I do not believe that it is sufficient …