What Organisms Cause Acute Epiglottitis in the Post- H. influenza Vaccination Era?

Discussion Epiglottitis is also known as supraglottitis and is caused by inflammation of the supraglottic structures and epiglottis. Usually the cause is infectious but other trauma such as thermal injuries or ingestions can also cause the disease. Before the widespread use of its conjugated immunization, Haemophilus influenza type b was the most common cause and it was usually thought of as a pediatric disease process. In the pre-immunization time period, acute epiglottitis in children was 3.47-6.0 cases per 100,000, and in the post-immunization period has declined to 0.3-0.7 cases per 100,000. However it appears that < 1 year old children remain at increased risk in the post-immunization time period. Adult incidence has remained constant at 1-4 cases per 100,000. The average age range in the post-immunization period has increased to ~44 years. The adult presentation is also slightly different with odynophagia, dysphagia and voice changes being the most common signs. It may often have a slower clinical course too. For the pediatric population, respiratory distress, dysphagia and drooling are considered the classic signs, but any symptoms of respiratory distress should alert the clinician to also consider epiglottitis in the differential diagnosis. Many of the cases of pediatric epiglottitis occur in fully immunized children. Surface and blood cultures are often negative so empiric antibiotics are usually begun. Learning Point Infectious causes of acute epiglottitis include...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news