Life threatening acute epiglottitis in acute leukemia.
We report an 8-year-old boy who developed a life-threatening acute epiglottitis during induction chemotherapy for acute promyelocytic leukemia. He survived the infection with emergency tracheostomy, treatment with broad spectrum antibiotics and amphotericin, and the use of granulocyte-macrophage colony stimulating factor. No organism was identified. A literature review identified 18 cases of acute epiglottitis in cancer patients. Sixteen of them were suffering from hematologic malignancies and three patients had received bone marrow transplantation. Unlike the usual case of epiglottitis, the majority (15 out of 18) of affected patients were adults and none of the infections was associated with Haemophilus influenzae. Streptococcus pneumoniae and Candida albicans were the most frequently identified pathogens. Early recognition and aggressive supportive care are required for successful management.
Lee
Anselm C W
AC
Department of Paediatrics, Tuen Mun Hospital, New Territories, Hong Kong, China. aclee@graduate.hku.hk
Lam
S Y
SY
D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D016638:Critical Illness; D004826:Epiglottitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D008297:Male; D011859:Radiography; D014139:Tracheostomy