Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two adults were admitted to the University Hospital of Geneva with acute Haemophilus influenzae type b epiglottitis. The disease was characterized by rapid progression of sore throat, upper dysphagia, fever and dyspnea. Acute upper airway obstruction required emergency tracheotomy in both cases. The patients recovered under ampicillin therapy. All the 100 cases from the literature for which clinical data were available have been analyzed:--Epiglottitis in adult is not exceptional.--Haemophilus influenzae type b is the most common infective organism documented, and was found in all positive blood cultures but one.--The typical presentation is severe sore throat, with upper dysphagia, fever and dyspnea.--Clinical course is rapid and serious, and acute respiratory distress develops in 57% of cases; overall mortality is 27%.--Emergency routine tracheotomy appears to be the most reliable treatment.
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PMID:[Acute epiglottitides in the adult]. 30 60

Acute epiglottitis is a disease with significant mortality. The patient, usually an otherwise healthy pre-school child, develops a sore throat and muffled voice from swollen supraglottic structures, and may progress rapidly to respiratory arrest. Early diagnosis and airway maintenance can prevent these fatalities. Whether to secure an airway by tracheostomy or endotracheal intubation is the subject of much discussion. Nineteen series totalling 738 cases of epiglottitis plus 11 new cases are reviewed. These patients were treated as follows: Tracheostomy = 348 (3 deaths - 0.86%); Endotracheal intubation = 216 (2 deaths - 0.92%); medical management with no artificial airway = 214 (13 deaths - 6.1%). The difference in morbidity and mortality between tracheostomy or nasotracheal intubation is so slight that the choice should be determined by local factors. Medical management with no artificial airway should not be used in children.
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PMID:Acute epiglottitis: intubation versus tracheostomy. 65 16

The diagnosis, management and outcome in 12 adults with acute epiglottitis was reviewed. Painful dysphagia was a universal symptom and respiratory distress affected eight patients, six of whom required urgent airway intervention. All patients received parenteral antibiotics, ten received steroids and four received adrenaline. Respiratory distress resolved in two patients given adrenaline and airway intervention was avoided. Indirect laryngoscopy is the investigation of choice and this is preferable to neck radiology. Two patients died and it is stressed that this condition must be distinguished from other more common causes of a severe sore throat. The patient should be managed in a unit with the facilities and expertise to effect acute airway intervention.
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PMID:Acute epiglottitis in adults: a potentially lethal cause of sore throat. 769 36

Life threatening mediastinitis as a complication of acute epiglottitis is very rare. A 38-year-old male in previously good health was admitted to our hospital in a state of unconsciousness. Seven days prior to admission he had complained of a sore throat, dysphagia, high fever and dyspnea. A chest X-ray on admission showed widening of the mediastinum, mediastinal emphysema, subcutaneous emphysema and left pleural effusion. Bronchoscopy showed the swelling of supraglottic structures. He was diagnosed as having acute mediastinitis and pyothorax as a complication of acute epiglottitis, but pathogens were not identified. The blood was hyperglycemic and insulin therapy was started. Though he gradually improved by massive antibiotic therapy, steroid therapy, tracheotomy and surgical drainage of both the left thoracic cavity and the mediastinum, he died suddenly of massive hemoptysis. Autopsy revealed that the acute mediastinitis had healed, but that the Aspergillus infection was present in both lungs and the pericardium. The Aspergillus infection was not lethal in the present case, and it seemed that death had resulted from arterial hemorrhage caused by erosion of the trachea. The present case suggests the need for antifungal therapy even in non-immunocompromised patients in particular when massive doses of antibiotics and steroids are administered.
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PMID:[A case of mediastinitis and bilateral pyothorax, following acute epiglottitis with concurrent Aspergillus infection]. 140

A 20-year retrospective review of 236 children with epiglottitis was performed to determine the frequency of occurrence of 21 presenting signs and symptoms. To determine the association of age with clinical presentation and diagnosis of epiglottitis, the signs and symptoms of children less than 2 years old were compared with those of children 2 years of age and older. Fifty-eight children (25%) were less than 2 years old. Sore throat was the only factor significantly different in the two age groups (P less than .01), occurring more commonly in the older children. There were 128 children (54%) with blood cultures positive for Haemophilus influenzae. Analyses of patients with positive blood cultures gave similar results. The signs and symptoms that clinically support epiglottitis in children less than 2 years old are similar in older children.
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PMID:Epiglottitis: comparison of signs and symptoms in children less than 2 years old and older. 229 56

From 1987 to 1989, 14 adults with acute epiglottitis were seen and treated at the ENT clinic of Geneva. All patients presented with a severe sore throat as primary symptom. An indirect laryngoscopy, which bears no risk in adults, was performed and revealed a swollen, cherry-red epiglottis. The course of the disease is unpredictable, and rapid development of airway obstruction may occur. In most cases, these patients can be treated medically with antibiotics and corticoids, and there is no need for systematic orotracheal intubation. However, patients presenting with respiratory distress syndrome or stridor require intubation, which may be impossible because of edema of the epiglottis. Therefore, a surgeon must be ready to perform a tracheotomy.
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PMID:[Epiglottitis in adults]. 239 55

Acute epiglottitis was diagnosed infrequently in adults until the late 1960s and early 1970s. Because it is relatively rare, it may present a problem to the physician who sees an adult with sore throat and dysphagia, but does not think of epiglottitis. In this paper, we report our experience with 48 cases of acute epiglottitis in adults between the years 1963 and 1987. A discussion of the diagnosis and treatment of adult epiglottitis is presented. An adult with acute painful dysphagia should be considered to have epiglottitis until the diagnosis is proven otherwise.
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PMID:Acute epiglottitis in adults. A review of 48 cases. 317 4

Acute epiglottitis in adults is a potentially fatal but self-limiting disease of increasing incidence world-wide. Forty-two patients, seen consecutively over a four year period at the ENT Department, Singapore General Hospital were reviewed retrospectively. A strong male predominance with a peak age incidence in the sixth decade was noted. A severe sore throat and dysphagia with disproportionate signs of oropharyngeal inflammation was the main presenting picture. Only three patients had stridor on presentation. Vigilant monitoring of the airway with empirical high-dose intravenous ampicillin, cloxacillin and steroids resulted in a dramatic clinical improvement in most patients and none developed stridor after admission. The yield from throat swabs and blood cultures were low. Two patients developed complications, a Ludwigs angina and an epiglottic abscess. Recurrent epiglottitis was a problem in one patient. There was low morbidity and no mortality on the management regime outlined.
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PMID:Acute epiglottitis in adults (the Singapore experience). 320 35

Acute epiglottitis is seldom encountered in adults, but the condition is probably more frequent than reported in the literature. Nineteen cases of adult epiglottitis were analysed retrospectively. In 53% of the patients, the symptoms were present for less than 24 h prior to hospitalization. Sore throat and dysphagia were invariably present. Three patients presented with stridor and 2 with complete airway obstruction. Throat cultures from 5 patients grew beta-haemolytic streptococci and from 2 Haemophilus influenzae type B was grown. Two tracheotomies and 1 nasotracheal intubation were performed. One death occurred. It is emphasized that any adult with an acute sore throat and dysphagia should undergo indirect laryngoscopy and that blood cultures should always be part of the routine bacteriological investigation. Cooperation and understanding among otolaryngologists and anaesthesiologists is of paramount importance in the management of acute adult epiglottitis, as nasotracheal intubation and cricothyroidotomy appear to be the methods of choice in securing an airway. Ampicillin and chloramphenicol are recommended in the medical treatment.
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PMID:Acute epiglottitis in adults: bacteriology and therapeutic principles. 332 11

Epiglottitis may occur at any age. The typical presentation in the young child and young adult is well known, but the presentation in patients at the extremes of age has not been characterized. At our locale, from 1974 to 1984, 19 children 24 months of age or less and, from 1979 to 1984, 9 adults 50 years of age or greater with epiglottitis were seen in the emergency department. In the infantile group, rapidly progressive interference with swallowing, vocalization, and respiration was encountered in less than half the patients. Symptoms were often prolonged before parents sought attention for their child. No preference was shown for maintenance of the upright position while at rest, as recumbency did not promote stridor or initiate respiratory distress. Respiratory complaints were common and included cough, tachypnea, and retractions. Drooling or retention of pharyngeal secretions was uncommon. The adult population had a history of symptoms that spanned several days. Extreme sore throat, pooling of oral secretions, muffled voice, and elevated temperature were uncommon. Dysphagia and mild respiratory complaints were frequent. Upper airway obstruction did occur. At both extremes of age, exceptions to the classic clinical pattern of epiglottitis occurred with significant frequency. Despite this, diagnosis and management in the emergency department were appropriate in most cases.
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PMID:Epiglottitis at the extremes of age. 337 97


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