[Epiglottitis in adults in general practice: difficult to recognise and life-threatening].
Epiglottitis is a rare and life-threatening cause of acute sore throat. Usually, epiglottitis is caused by a bacterium, such as Haemophilus influenzae type b. Symptoms of epiglottitis are acute and rapidly progressive sore throat, a hoarse voice, fever, and drooling. We present two adult patients with acute sore throat who were diagnosed with epiglottitis. In adults with symptoms compatible with epiglottitis, it is justified to look down the throat with a light. Only if the view is impeded should a spatula be used but carefully. If there is a discrepancy between the severity of symptoms and few or no abnormal findings on examination of the throat, epiglottitis should be considered. If epiglottitis is suspected, referral to an ENT specialist is always indicated. Symptoms of upper airway obstruction, such as drooling, dyspnoea, inspiratory stridor and fear or anxiety, are an indication for emergency referral by ambulance.
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht.
Corlien J H
CJ
de Vries
Egbert
E
de Jongh
Sjoerd
S
Zwart
E H Jet
EH
van den Akker
Wim
W
Opstelten
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004417:Dyspnea / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D004826:Epiglottitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D058006:General Practice; D006192:Haemophilus Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012135:Respiratory Sounds; D012798:Sialorrhea
D000900:Anti-Bacterial Agents