title: A new era in supraglottitis? An isolated UK case of supraglottitis secondary to Neisseria meningitidis.
abstract: OBJECTIVE
  We report the first UK case of supraglottitis secondary to Neisseria meningitidis.
  
  
  METHODS
  Case report with review of the current literature on supraglottitis and its aetiology.
  
  
  RESULTS
  An 89-year-old woman was referred with worsening symptoms of dysphagia, hoarseness and neck discomfort. After nasopharyngoscopy and neck X-ray, supraglottitis was diagnosed. Prompt treatment comprised nebulised adrenaline, oxygen therapy and intravenous antibiotics. Microbiology samples grew N meningitidis, a notifiable disease in the UK. Public health officials were informed, and full precautions and prophylactic treatment initiated for those at risk. The patient made excellent progress and was discharged several days later.
  
  
  CONCLUSIONS
  Supraglottitis occurs in <4 per 100 000 population. Following a successful UK childhood immunisation programme, most cases occur in adults. Supraglottitis secondary to N meningitidis is exceptionally rare, with only seven other reported cases worldwide. Morbidity is exceptionally high; over 60 per cent of patients require airway intervention. To our knowledge, this is the first reported UK case of supraglottitis secondary to N meningitidis. This case highlights the important clinical, diagnostic and therapeutic interventions required to prevent complications associated with this potentially fatal condition.
authors.affiliation: Department of Otorhinolaryngology, Salisbury District Hospital, UK. u.sarwar@doctors.org.uk
authors.forename: U
authors.initials: U
authors.lastname: Sarwar
authors.forename: N
authors.initials: N
authors.lastname: Akhtar
authors.forename: J
authors.initials: J
authors.lastname: Hemming
authors.forename: S
authors.initials: S
authors.lastname: Dennis
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000517:prevention & control; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016358:Contact Tracing; D003680:Deglutition Disorders / Q000209:etiology; D003907:Dexamethasone / Q000627:therapeutic use; D018563:Disease Notification; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007828:Laryngoscopy; D008589:Meningococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D009333:Neck; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D010100:Oxygen / Q000627:therapeutic use; D011634:Public Health; D035583:Rare Diseases; D059525:Supraglottitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D010100:Oxygen; D004837:Epinephrine