Evaluation of patients with adult acute epiglottitis

Year 2007, Volume: 17 Issue: 3, 152 - 157, 23.05.2007

Adin Selçuk Hüseyin Dere Işıl Taylan Mehmet Ali Çetin Serdar Ensari

Abstract

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 epiglot­ titis during an eight-month period. AH 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 ali 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 laryn- goscopic examination and lateral radiograms of the neck, which showed the thumb sign in ali the patients.Computed tomography of the neck revealed an epiglot- tic abscess in one patient. One patient required tra- cheotomy. AH 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.

Keywords

Adult, airway obstruction/etiology, epiglottitis/drug therapy

Akut epiglottitli erişkin olguların değerlendirilmesi

Abstract

Amaç: Akut epiglottit nedeniyle tedavi edilen erişkinolgular değerlendirildi.Hastalar ve Yöntemler: Çalışmaya sekiz aylık birdönem içinde kliniğimizde akut epiglottit saptananbeş erişkin hasta sunuldu. Hastaların tümü erkektive 77 yaşında bir hasta dışında, yaşları 38-54 arasında değişmekteydi. Hastaların başvuru anındakisolunum sıkıntısı ve semptomların derecesi Friedman sınıflamasına göre değerlendirildi. Hastalaraparenteral steroid ve antibiyotik tedavisi uygulandı.Ortalama takip süresi bir yıl dağılım 11-17 ay idi.Bulgular: Tüm hastalarda asıl başvuru yakınmasısolunum sıkıntısıydı. Solunum sıkıntısının derecesibir hastada Friedman evre 4, iki hastada 3, iki hastada 2 idi. Tanı, larenks muayenesi ve boyun yan filmi ile kondu. Boyun radyografisinde tüm hastalardakalınlaşmış epiglot, “başparmak belirtisi” izlendi. Boyun ve larenks bilgisayarlı tomografisinde bir olgudaepiglot apsesi görüldü. Bir hastada trakeotomi gerekti. Parenteral steroid ve antibiyotik tedavisi sonucunda tüm olgularda solunum sıkıntısı geçti ve yutma güçlüğü düzeldi. Hastanede kalış süresi ortalama 5-6 gün dağılım 3-8 gün idi. Takip sırasındahiçbir hastada nüks görülmedi.Sonuç: Akut epiglottitli erişkin hastalarda doğru tanızamanında konmalı, zaman kaybetmeden uygun tedaviye başlanmalı ve gerektiğinde trakeotomidenkaçınılmamalıdır

Keywords

Erişkin, havayolu tıkanıklığı/etyoloji, epiglottit/ilaç tedavisi

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