title: Acute epiglottitis in Iceland 1983-2005.
abstract: OBJECTIVE
  To describe the changes in the epidemiology of epiglottitis in Iceland from 1983 to 2005.
  
  
  METHODS
  All patients with the discharge diagnosis of epiglottitis during the study years were identified and diagnosis confirmed by chart review. Main outcome measures were age, gender, month/year of diagnosis, microbiology, airway management, ICU admissions, choice of antibiotics, length of hospital stay and major complications/mortality.
  
  
  RESULTS
  Fifty-seven patients were identified (annual incidence 0.93/100.000). The mean age was 33.3 years (1-82). Childhood epiglottitis disappeared after introduction of Haemophilus influenzae type b (Hib) vaccination in 1989 but adult disease showed non-significant increase. In the pre-vaccination era Hib was the most common organism cultured but it has not been diagnosed in Iceland since 1991 and Streptococci are now the leading cause of epiglottitis. The mean hospital stay was 5.05 nights with 51% of patients admitted to ICU. All children under 10 years and a total 30% of patients received airway intervention. Ninety percent of adults were observed without airway intervention. Major complications were rare and mortality was 0% in our series.
  
  
  CONCLUSIONS
  There have been major changes in the epidemiology of epiglottitis in Iceland during the study period. Previously a childhood disease, epiglottitis has disappeared in children and is now almost exclusively found in adults. This can be attributed to widespread Hib vaccination, eliminating the major causative agent in children. The treatment of this life-threatening disease remains a challenge. Our series suggest that it is safe to observe patients with mild/moderate symptoms without airway intervention.
authors.affiliation: Department of Otolaryngology, Buskerud Central Hospital, Dronninggata 28, 3004 Drammen, Norway. birgir.briem@gmail.com
authors.forename: Birgir
authors.initials: B
authors.lastname: Briem
authors.forename: Ornolfur
authors.initials: O
authors.lastname: Thorvardsson
authors.forename: Hannes
authors.initials: H
authors.lastname: Petersen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004826:Epiglottitis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D018073:Haemophilus Vaccines; D019741:Haemophilus influenzae type b / Q000302:isolation & purification; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D017678:Sex Distribution; D013291:Streptococcus / Q000302:isolation & purification; D014140:Tracheotomy / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D018073:Haemophilus Vaccines