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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Sore throat can be caused by different microorganisms and diseases. Most cases of acute pharyngitis are caused by group A streptococcus or viruses; however, uncommon organisms may be suggested by other clinical information or the persistence of symptoms. A thorough history and physical examination are essential for the appropriate selection of diagnostic tests for sore throat. Routine testing for the uncomplicated case should consist of a pharyngeal culture in most patients, with rapid streptococcal antigen testing only for the more severe cases. Those with positive streptococcal tests should be treated to prevent rheumatic fever and mitigate symptoms in severe cases. Sore throat caused by viruses usually resolves spontaneously. Cases that persist should be thoroughly re-evaluated, with alternative causes being considered. Acute epiglottitis is a medical emergency and requires treatment with appropriate antibiotics for Hemophilus influenzae type b and intubation.
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PMID:The sore throat. Pharyngitis and epiglottitis. 307 5

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

Acute epiglottitis may be fatal when diagnosis is delayed. The literature stresses data that does not help to predict impending airway obstruction in patients who present with a sore throat, the most consistent presenting symptom among patients with acute epiglottitis. In this review of 80 cases of epiglottitis in adults, almost all patients who presented within eight hours from onset of symptoms required airway intervention, while the majority of those who presented more than eight hours after onset of symptoms never developed acute upper respiratory obstruction and were treated medically or had supportive treatment only. Artificial airway was indicated in all patients who had drooling. There were no fatalities in this series, however, we recommend keeping all patients with acute epiglottitis in an intensive care unit for at least 24 hours after admission.
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PMID:Acute epiglottitis in the adult. 397 79

Acute epiglottitis may be more common in adults than is generally believed, but the diagnosis is often missed. Three cases of adults with epiglottitis are reported. The presenting signs and symptoms included sore throat, dysphagia, symptoms disproportionate to pharyngeal findings, and tenderness over the neck anteriorly. All three patients had a benign course, but acute upper airway obstruction can occur. The diagnosis was established in each case by mirror or flexible fiberoptic laryngoscopy, lateral neck radiographs, or both. Treatment consisted of maintenance of a patent airway and administration of humidified oxygen and antibiotics.
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PMID:Epiglottitis in adults. 646 36

Acute epiglottitis in adults is probably commoner than is generally appreciated. Although upper airway obstruction can occur, the course most often is benign. Acute epiglottitis should be suspected in all patients with a sore throat and dysphagia, especially if symptoms are out of proportion to pharyngeal findings. Diagnosis can be established by mirror or flexible fiberoptic laryngoscopy, lateral radiography of the neck, or both. Treatment consists of maintenance of a patent airway and use of humidified oxygen and antibiotics (ampicillin and chloramphenicol [Chloromycetin] ). The role of corticosteroids in treatment of epiglottitis is still controversial.
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PMID:Epiglottitis in the adult. Recognizing and treating the acute case. 670 Nov 34

Acute epiglottitis in adults occurs more frequently than generally realized. Haemophilus influenzae type b is the major causative agent. While H influenzae resistant to ampicillin sodium has been associated with epiglottitis in children, no adult cases have been reported. We describe a 48-year-old woman with epiglottitis and associated typical rapid onset of sore throat, fever, respiratory distress, and swollen, red supraglottic structures. Blood cultures were positive for beta-lactamase-producing, ampicillin-resistant H influenzae. We conclude that H influenzae resistant to ampicillin should be considered when diagnosing and treating adult epiglottitis.
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PMID:Acute epiglottitis and bacteremia with ampicillin-resistant Haemophilus influenzae. 698 Jun 42

Acute epiglottitis in adults is a fulminant disease characterized by local cellulitis of supraglottic structures. Symptoms include sore throat, dysphagia, respiratory difficulty and muffled voice. Signs are pharyngitis, swollen and inflamed epiglottis, epiglottic abscess and/or cervical swelling. Diagnosis is facilitated by an upright, lateral neck x-ray and indirect laryngoscopy. The mainstays of treatment are airway maintenance, antibiotics, steroids, hydration, cool mist, oxygen and supportive care.
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PMID:Acute epiglottitis in adults. 710 96


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