[Evaluation of patients with adult acute epiglottitis].

OBJECTIVES: We evaluated adult patients who were treated for acute epiglottitis.

PATIENTS AND METHODS: The study included five adult patients who were diagnosed as having acute epiglottitis during an eight-month period. All the patients were males with an age range of 38 to 54 years, except for a 77-year-old patient. The Friedman staging system was used to evaluate the severity of dyspnea and symptoms. Treatment was comprised of parenteral steroids and antibiotic therapy. The mean follow-up was one year (range 11 to 17 months).

RESULTS: The main presenting symptom was moderate to severe dyspnea in all the patients, which was rated as stage 4 in one patient, stage 3 in two patients, and stage 2 in two patients. Diagnoses were made by laryngoscopic examination and lateral radiograms of the neck, which showed the thumb sign in all the patients. Computed tomography of the neck revealed an epiglottic abscess in one patient. One patient required tracheotomy. All the patients benefited from parenteral steroid and antibiotic treatment, with relief of dyspnea and difficulty in swallowing. The mean hospitalization was 5.6 days (range 3 to 8 days). No recurrences were observed during the follow-up period.

CONCLUSION: Acute epiglottitis in adult patients requires a timely and correct diagnosis and prompt appropriate treatment. A tracheotomy should not be avoided when necessary.