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J Korean Soc Emerg Med > Volume 27(1); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(1): 126-133.
Clinical Features of Acute Epiglottitis in Adults in the Emergency Department
Kyoung Min You1, Woon Yong Kwon1, Gil Joon Suh1, Kyung Su Kim1, Jae Seong Kim2, Min Ji Park1
1Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
2Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea
Correspondence  Woon Yong Kwon ,Tel: 02) 2072-0326, Fax: 02) 3672-8871, Email: kwy711@hanmail.net,
Received: December 17, 2015; Revised: December 17, 2015   Accepted: December 24, 2015.  Published online: February 29, 2016.
ABSTRACT
Purpose:
Acute epiglottitis is a potentially fatal condition that can result in airway obstruction. The aim of this study is to examine the clinical features of adult patients who visited the emergency department (ED) with acute epiglottitis.
Method:
This retrospective observational study was conducted at a single tertiary hospital ED from November 2005 to October 2015. We searched our electronic medical records (EMR) system for a diagnosis of “acute epiglottitis” and selected those patients who visited the ED.
Results:
A total of 28 patients were included. There was no pediatric case with acute epiglottitis during the study period. The mean age of the patients was 58.0±14.8 years. The peak incidences were in the sixth (n=7, 25.0%) and eighth (n=8, 28.6%) decades. The male-to-female ratio was 2.1:1. The most common symptom was sore throat (n=23, 82.1%), followed by dyspnea (n=15, 53.6%), hoarseness (n=7, 25.0%), fever (n=6, 21%), and dysphagia (n=5, 17.9%). The diagnosis of acute epiglottitis was confirmed when edema and hyperemia of the epiglottis were visualized by laryngoscopy. Twenty-six patients were treated conservatively with antibiotics and steroids without definite airway management. Two patients were intubated, but no patients required tracheostomy.
Conclusion:
In adult patients with acute epiglottitis, sore throat and dyspnea were the most common symptoms but fever was infrequent. Most patients improved with conservative management only. Definite airway management was required in only two patients in whom endotracheal intubations were performed successfully in the ED by emergency physicians, and surgical airway management was not required.
Key words: Epiglottitis, Emergency medical services, Fever, Intratracheal Intubation
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