Acute Epiglottitis in Adults

Acute infective inflammation of the epiglottis and supraglottic tissues is a wellrecognised entity in children.The first description of this condition in the Australian literature, in 1946, was of 15 cases in children and one in an adult.I By 1983, over 300 adult cases had been described worldwide.This paper describes the clinical course of five adults with epiglottitis, and discusses the aetiology and management of the condition in this age group. CLINICAL DETAILS Patient No. 1:A previously healthy 46-year-old woman presented with a six-hour history of a severe sore throat and progressive difficulty with swallowing and breathing.Her local doctor had noted tachycardia, tachypnoea and extreme apprehension.Further findings in hospital were fever (38.4 DC), central cyanosis, expiratory grunting, a pharyngeal swelling, and very tender submandibular nodes.Her white cell count was 4,400, with a shift to the left and she had a thrombocytopaenia of 72,000.Arterial blood gas analysis revealed a respiratory acidosis (pH 7.29, P02 80, PC02 55 mmHg, FI02 0.21).Throat swabs and blood cultures were taken and she was given intravenous