Adult Supraglottitis

Abstract

Epiglottitis in pediatric patients is an infection caused byHaemophilus influenzaetype b, which can lead rapidly to sepsis and an asphyxial death. In an effort to study the cause and clinical course of adult epiglottitis, eight serially hospitalized adult patients with supraglottitis over a ten-month period were prospectively evaluated, including a daily laryngeal examination. Although multiple anatomic sites in the larynx and oropharynx were inflamed, the epiglottis was often not the most involved area and was actually normal in one patient. Bacterial cultures were harvested from blood, the nasopharynx, the oropharynx, and the vallecula in all patients and the preepiglottic space in two patients. In no case wasH influenzaedemonstrated. No patient developed respiratory compromise. It was concluded that epiglottitis is an inaccurate description of this disorder and that this non—H influenzaeadult variety of supraglottitis seemingly can follow a less pernicious course than the classically described infection. (JAMA1988;259:563-567)