Acute epiglottitis: epidemiology, clinical presentation, management and outcome.
OBJECTIVE
To describe the incidence trends, clinical presentation, management and outcome of acute epiglottitis in a Danish population after the introduction of Haemophilus influenzae type b vaccine.


METHODS
Retrospective review of the health records of all patients discharged with a diagnosis of acute epiglottitis from the otolaryngology department, Roskilde County Hospital, Denmark, from 1996 to 2005.


RESULTS
One infant and 34 adults were identified. The incidence of acute epiglottitis in children was 0.02 cases/100,000/year. Before introduction of the H influenzae type b vaccination (1983-1992), the mean national incidence of acute epiglottitis was 4.9 cases/100,000/year. The incidence of acute epiglottitis in adults was constant, with a mean value of 1.9 cases/100,000/year. Twenty-nine per cent of the patients required an artificial airway, and respiratory distress was found to be associated with airway intervention (p = 0.010). All patients recovered completely.


CONCLUSIONS
In the H influenzae type b vaccine era, acute epiglottitis in children has almost disappeared. The incidence in the adult population has been constant. A discriminate approach to airway management seems safe in adults.
Guldfred
L-A
LA
Department of Otolaryngology, Roskilde County Hospital, Denmark. liviu@hlaug.dk
Lyhne
D
D
Becker
B C
BC
D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016667:Bacterial Capsules / Q000008:administration & dosage; D003718:Denmark / Q000453:epidemiology; D004826:Epiglottitis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D019741:Haemophilus influenzae type b; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012621:Seasons; D016896:Treatment Outcome; D014611:Vaccination
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine