Materiały źródłowe

• #1 Epiglottitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21236

  Epiglottitis was once thought to affect young children primarily but is now increasingly observed in adults. In the United States, about 1 case per 100,000 people occurs annually, with a consistent rate among adults. The introduction of the Hib vaccine in 1985 significantly reduced childhood epiglottitis, particularly among 2- to 4-year-olds, in whom it is now a rare occurrence. […] The childhood-to-adult case ratio dropped from 2.6:1 in 1980 to 0.4:1 in 1993, though vaccine failures do occur. In countries without widespread Hib vaccination, incidence may vary. Epiglottitis diagnoses have risen despite immunization in the United Kingdom, possibly due to severe airway infections like bacterial tracheitis. […] Additionally, after vaccine implementation, the average age of affected children shifted to those aged between 6 and 12.

• #1 Epiglottitis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/epiglottitis-pro

  Epiglottitis is rare, affecting 1-4/100,000 population. […] Since the widespread introduction of Haemophilus Influenza type B (Hib) vaccination, acute epiglottitis is now extremely rare in children. […] Some studies suggest an increased prevalence in adults, thought to be related to miscellaneous pathogenic bacteria. […] The usual age of presentation in children is 2-5 years. Adults present in their 40s and 50s and it affects more men than women. […] Adults who develop epiglottitis are more likely to have other underlying medical conditions that affect their immunity either systemically or locally. […] Hib vaccination has dramatically reduced the incidence of acute epiglottitis in children in those countries in which the vaccination is included in the routine vaccination protocol for children.

• #1 Epiglottitis – TeachMePaediatrics

  https://teachmepaediatrics.com/ent/throat/epiglottitis/

  Epiglottitis is rare, only affecting approximately 1-4/100,000 people (4,7). The number of children presenting with acute epiglottitis has reduced significantly since the introduction of the Haemophilus influenza B (Hib) vaccine in 1985 (not introduced into routine screening programme in the UK until 1992 (9)) The average age of presentation has increased from 3.5 pre-vaccine to 14.6 post-vaccine(5). […] Infectious causes of epiglottitis are more common that non-infectious causes, though both are listed below. As already discussed, Haemophilus influenza type B used to be by far the most common cause of epiglottitis amongst children, accounting for 75-90% of cases (6). Bacteria still predominate in the list of causes, with the majority post the introduction of the HiB vaccine being caused by streptococcus species (1,7).

• #2 Epiglottitis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/963773-overview

  Epiglottitis is classically associated with Haemophilus influenzae type b (Hib) infection and children. However, as has been observed with other infections caused by this agent, the overall incidence of epiglottitis has dramatically dropped in young children globally, as well as older age groups and adults, upon general adoption of Hib vaccine; furthermore, the most typical patient affected by epiglottitis in industrialized areas with vaccination programs is now an urban male in his mid 40s. Groups with higher morbidity include infants younger than 1 year and adults older than 85 years. […] In United States, epiglottitis is an uncommon disease with an incidence in adults of about 1 case per 100,000 per year. Adult epiglottitis is most frequently a disease of men (male-to-female ratio, approximately 3:1), occurring during the fifth decade of life (average age, about 45 y). The ratio of incidence in children to adults was 2.6:1 in 1980 and dropped to 0.4:1 in 1993, a dramatic decrease in occurrence since the introduction of the Haemophilus influenzae type b vaccine (Hib). However, keep in mind that vaccine failures are possible.

• #3 Acute epiglottitis: epidemiology, clinical – ProQuest

  https://www.proquest.com/scholarly-journals/acute-epiglottitis-epidemiology-clinical/docview/274972042/se-2

  Acute epiglottitis is a potentially life-threatening infection of the supraglottic structures, which can lead to sudden, fatal airway obstruction. Historically, acute epiglottitis was initially described as a disease of adults, but from the 1960s onwards it has been considered to be mainly a paediatric disease. The introduction of the conjugate vaccines against Haemophilus influenzae type b in western countries led to a dramatic decline in the incidence of acute epiglottitis in children. Subsequently, the focus shifted again towards acute epiglottitis in adults, in whom the disease was now more common than in children. There have been several reports of an increasing incidence of acute epiglottitis in adults. Over the last six to seven years, the incidence of acute epiglottitis in children in the UK has started to rise again, suggesting that acute epiglottitis may be on the uprise in the paediatric population.

• #3 Epiglottitis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/963773-overview

  Globally, epiglottitis is generally more common in nations that do not immunize against H influenzae type b. For example, in Sweden from 1987 to 1989, the incidence was 14.7 per 100,000 people per year in children aged 0-4 years and 3.2 per 100,000 people per year overall. A large-scale Hib vaccination program in 1992-1993 resulted in a substantial decrease in Swedish cases of acute epiglottitis. […] A retrospective review of a Danish population demonstrated a mean national incidence of epiglottitis in children of 4.9 cases per 100,000 per year in the decade before Hib vaccination. From 1996 to 2005, with the introduction of widespread Hib vaccination, an incidence of only 0.02 cases of epiglottitis per 100,000 per year was seen. During this period, the incidence of acute epiglottitis in adults remained constant, at 1.9 cases per 100,000 per year.

• #4 Acute epiglottitis: epidemiology, clinical presentation, management and outcome | The Journal of Laryngology & Otology | Cambridge Core

  https://www.cambridge.org/core/journals/journal-of-laryngology-and-otology/article/acute-epiglottitis-epidemiology-clinical-presentation-management-and-outcome/ADE87EE42B41869871F2DFD38CE06A46

  Aims: To describe the incidence trends, clinical presentation, management and outcome of acute epiglottitis in a Danish population after the introduction of Haemophilus influenzae type b vaccine. […] The incidence of acute epiglottitis in children was 0.02 cases/100 000/year. Before introduction of the H influenzae type b vaccination (1983-1992), the mean national incidence of acute epiglottitis was 4.9 cases/100 000/year. The incidence of acute epiglottitis in adults was constant, with a mean value of 1.9 cases/100 000/year. […] In the H influenzae type b vaccine era, acute epiglottitis in children has almost disappeared. The incidence in the adult population has been constant.

• #5 Epiglottitis | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617227/all/Epiglottitis?q=Penicillin

  Epiglottitis caused by Haemophilus influenzae type B occurs most often between the ages of 1 and 7 years (overall range: infancy to adulthood). […] Epiglottitis and other invasive disease secondary to H. influenzae type B have been reduced by 99% since the introduction of the conjugate vaccines in 1987 (approved for use at 15 months) and 1990 (approved for use at 2, 4, and 6 months). […] Nontypeable H. influenzae now appears to be a more common cause of invasive disease than type B. […] Year-round occurrence […] All geographic areas […] Can have secondary cases in households or child care centers […] May be more frequent in children with sickle cell anemia, asplenia, immunoglobulin defects, or hematologic malignancies (e.g., leukemia) […] Increasing ratio of adult to pediatric cases. […] Incidence of pediatric epiglottitis due to any organism has declined in the postvaccine era (0.3 to 0.7/100,000 per year from 3.47 to 6/100,000 per year). […] Incidence in adults has remained steady (1 to 4/100,000 per year).

• #6

  https://journals.lww.com/jcsr/fulltext/2020/09020/acute_epiglottitis___a_life_threatening_clinical.8.aspx

  Acute epiglottitis (AE) is an acute inflammatory life-threatening clinical condition which can lead to obstruction of the airway. […] The epidemiology of AE has now changed with an increasing number of adults being affected. In adult age group, AE differs from that in paediatric age group, and in adults, it is a less severe, non-bacterial infection and has longer days of the symptoms with a chief complaint of throat pain. […] After introducing Hib vaccinations in childhood immunisation programs, there is a significant decline in the incidence of AE among paediatric age group along with an increase among adults. […] In post-vaccination era, the annual incidence of paediatric AE is 0.30.7/100,000 patients with the frequency among adult age group now greater than paediatric age group.

• #7 Epiglottitis – Combat Medicine 101

  https://combatmedicine101.com/epiglottitis/

  Historically, most cases of epiglottitis only affected children under the age of 5 and it was predominantly caused by H. influenza type B. But since the widespread adoption of Hib vaccinations, the incidence of epiglottitis has decreased by more than 90%. […] In the post-Hib-vaccine era, Streptococcus and Staphylococcus are now the leading causes of epiglottitis. […] The average age of patients with epiglottitis is 45. […] 16% of patients require intubation and 3% of patients require a surgical airway. […] The majority of patients with acute epiglottitis typically recover without residual airway or other problems if the airway is promptly secured and appropriate antimicrobial therapy is administered.

• #8

  https://link.springer.com/article/10.1007/s13546-016-1193-4

  Historically, acute epiglottitis occurred in young children and the most common causative organism was Haemophilus influenzae type b (Hib). Since the introduction of the Hib vaccine, the incidence of epiglottitis among children has declined, whereas the incidence among adults has increased. The typical profile of an adult patient with acute epiglottitis seems to be a middle-aged patient with a male predominance. […] La mortalit est faible. Cependant, une volution fatale par arrt cardiaque hypoxique est possible, et imprévisible, en cas d’obstruction des VAS. […] Most patients can be closely monitored in the Intensive Care Unit, without the need for an airway intervention. However, in severe epiglottitis, the focus of treatment is the maintenance of a patent airway, using intubation or tracheotomy. Mortality remains low, but hypoxic cardiac arrest can occur without warning, due to airway obstruction.

• #9 Epiglottitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Epiglottitis_epidemiology_and_demographics

  In North America, approximatley 1.3 per 100,000 children are affected per year. In adults, the incidence is between 1 and 4 per 100,000 per year. […] December is observed to be the month with highest number of cases whilst April is the least. […] Males are more commonly affected with epiglottitis in USA than females. The male to female ratio is approximately 3:2. […] The disease used to be mostly found in pediatric age group between 3 to 5 years. However, recent trend favors adults as most commonly affected individuals with a mean age of 44.94 years. Recent data suggest an increase in those between 45 to 64 years old as well as those over 85 years whilest those below 18 years is decreasing. […] In USA, epiglottitis is more prevalent in the caucasian race in urban communities accounting for over 2/3rd of all epiglottitis admissions. […] Epiglottitis occurs more commonly in developing countries. […] With the advent of Haemophilus influenza type b vaccine, the prevalence of epiglottitis has reduced by 90%.

• #10 Epiglottitis – TeachMePaediatrics

  https://teachmepaediatrics.com/ent/throat/epiglottitis/

  Epiglottitis is a serious condition and early recognition is essential to prevent airway compromise. Maintain a high index of suspicion and do not try to confirm the diagnosis on your own. Groups with highest morbidity include infants 1y and adults 85y(4). However, with reduced cases and improved awareness, deaths are rare (1 in 100 cases)(2).

• #11 Causes, symptoms and details of Epiglottitis – Pulse Reference

  https://pulsereference.com/diagnoses/epiglottitis/

  The incidence of epiglottitis has significantly decreased in the UK following the Hib vaccination programme. Presently, it is more commonly observed in adults than in children. The condition remains rare but can affect all age groups, with a slight male predominance. […] However, since the introduction of the Hib vaccine, the epidemiology has shifted towards other organisms like Streptococcus pneumoniae and Staphylococcus aureus.

• #12 Haemophilus influenzae Type f Epiglottitis in a 3-Year-Old Boy | Consultant360

  https://www.consultant360.com/articles/haemophilus-influenzae-type-f-epiglottitis-3-year-old-boy

  Other infectious agents in the vaccination era associated with epiglottitis include nontype b H influenzae, group A streptococci, Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus parainfluenzae, and -hemolytic streptococci (groups B, C, and F). Candidal and viral infections (herpes simplex type 1, varicella-zoster, and parainfluenza) also have been implicated, particularly in immunocompromised individuals. Acute epiglottitis has a significant male predominance, with 63% of children with it being boys.

• #13 Subacute Epiglottitis Causing Polypoid Laryngeal and Glottic Masses | Published in Journal of Brown Hospital Medicine

  http://bhm.scholasticahq.com/article/57590-subacute-epiglottitis-causing-polypoid-laryngeal-and-glottic-masses

  Epiglottitis, or supraglottitis, is inflammation of the glottis and its surrounding structures. Despite being relatively rare, even mild cases can be highly distressing for patients and potentially fatal due to the epiglottis proximity to the airway. Traditionally, epiglottitis has been thought to be a disease of pediatric populations, although in recent decades the epidemiology has shifted in middle- and high-income countries, to include more adults than children due to the advent of large-scale vaccination and prevention measures in children. […] The most common cause of epiglottitis in both adults and children remains bacterial epiglottitis due to Haemophilus influenzae (H. Flu), although other contributing bacteria include most commonly Group B Streptococcus and other Streptococcus species.

• #14 Epiglottitis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/963773-overview

  A retrospective review from the tropical country of Singapore over 8 years, ending in 1999, demonstrated 32 cases of acute epiglottitis, only 1 of which occurred in a child. During this time, Hib immunization was not routine, so Hib immunization cannot be used to explain the increased adult epiglottitis prevalence found in this study.

• #15

  https://link.springer.com/article/10.1007/s00405-024-09042-9

  This study aimed to explore the new clinical characteristics and trends of acute epiglottitis (AE) in northern China. […] A retrospective, observational study was conducted on patients diagnosed with AE between January 2014 and December 2023 at a single-center medical institution in northern China. The clinical profiles of patients with AE were investigated. […] AE incidence rose annually over a decade, with mild seasonal variations. […] The incidence rate of AE is on the rise. […] The study indicates a slightly higher incidence of AE during winter and summer, though this finding was not statistically significant. […] Our findings reveal a yearly increasing trend in the incidence of AE, consistent with previous research reports. […] The annual case count of AE ranged between 17 and 46, with an overall increasing trend, escalating from 17 cases in 2014 to 45 cases in 2023.

• #16 Epidemiology, presentation, management and outcomes of patients with acute epiglottitis – A 10-year retrospective study based on a tertiary hospital in northern China | springermedizin.de

  https://www.springermedizin.de/epidemiology-presentation-management-and-outcomes-of-patients-wi/50128238

  This study aimed to explore the new clinical characteristics and trends of acute epiglottitis (AE) in northern China. […] A retrospective, observational study was conducted on patients diagnosed with AE between January 2014 and December 2023 at a single-center medical institution in northern China. […] AE incidence rose annually over a decade, with mild seasonal variations. […] The incidence rate of AE is on the rise. […] The study indicates a slightly higher incidence of AE during winter and summer, though this finding was not statistically significant. […] Our findings reveal a yearly increasing trend in the incidence of AE, consistent with previous research reports.

• #17 Epiglottitis – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/452/epiglottitis

  Epiglottitis is classically described in children aged 2 to 6 years of age; however, it may manifest at any age, including in newborns. In countries that have introduced routine Haemophilus influenzae type B (Hib) vaccination, it is now extremely rare in children and may be more common in adults. […] The rising incidence of adult acute epiglottitis and epiglottic abscess.

• #18 Subacute Epiglottitis Causing Polypoid Laryngeal and Glottic Masses | Published in Journal of Brown Hospital Medicine

  http://bhm.scholasticahq.com/article/57590-subacute-epiglottitis-causing-polypoid-laryngeal-and-glottic-masses

  Onset of epiglottitis caused by the strep species (subacute) tends to be more insidious in onset than epiglottitis from Hemophilus influenzae. Broadly speaking, epiglottitis secondary to strep species is relatively common, although case reports of epiglottitis caused specifically by group G streptococcus are rare but present in the literature. […] Group G Streptococcus is an uncommon pathogen, accounting for 1.5 percent of bacteremia in adults. However, recent trends across several nations have noted increasing proportion of infection cause by Group G strep over the last twenty years.

• #19 Subacute Epiglottitis Causing Polypoid Laryngeal and Glottic Masses | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/57590-subacute-epiglottitis-causing-polypoid-laryngeal-and-glottic-masses

  The most common cause of epiglottitis in both adults and children remains bacterial epiglottitis due to Haemophilus influenzae, a gram negative coccobacilli, despite widespread vaccination and overall reduction in incidence. Other contributing bacteria include most commonly Group B strep and other strep species. Viral pathogens that target the upper respiratory tract can also cause epiglottitis, both less commonly and less severely. It is also worth noting that any inflammation of the glottic area can induce epiglottitis, including inhalational injury or caustic ingestion. […] Recent trends across several nations have noted increasing proportion of infection cause by Group G strep over the last twenty years. Syndromes precipitated by Group G Streptococcus are most commonly pharyngitis, septic arthritis, skin and soft tissue infections, and bacteremia, but also includes endocarditis, meningitis, pneumonia, and epiglottitis among others.

• #20 Epiglottitis – Core EM

  https://coreem.net/core/epiglottitis/

  Epidemiology […] Uncommon disorder […] Incidence of 3-5:100,000 per year. Mortality between 7-20%. […] Mean age of those affected is 55. Child:adult ratio of 0.3:1. […] Risk factors include smoking, diabetes, immunocompromise. […] Broad range of causative organisms, but most commonly caused by various strep and staph species. […] […] […] Epiglottitis has demonstrated a resurgence in the adult population. It is no longer a pediatric only disease. […] […] […] The classic presentation of epiglottitis (3Ds of drooling, dysphagia and distress) is uncommon. […] […] […] Epiglottitis should be high on your differential for the bounce-back patient who continues to complain of worsening sore throat. […] […] […] Definitive diagnosis is made by flexible fiberoptic laryngoscopy. […] […] […] Be ready for a difficult airway.

• #21 Elevated risk of acute epiglottitis in patients with chronic obstructive pulmonary disease: A nationwide cohort study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0273437

  Elevated risk of acute epiglottitis in patients with chronic obstructive pulmonary disease: A nationwide cohort study […] In individuals with epiglottitis, chronic obstructive pulmonary disease (COPD) is a common comorbidity; however, the impact of COPD under such circumstances is not well documented. Therefore, we performed this population-based study to determine whether, in adults, COPD is a risk factor for epiglottitis. […] In the frequency matching, the cumulative epiglottitis incidence was significantly higher (p = 0.005) in the COPD cohort. According to the adjusted Cox proportional hazard model, COPD exhibited a significant association with elevated epiglottitis incidence (adjusted hazard ratio: 1.76; 95% confidence interval: 1.15-2.70, p = 0.009). Similar trend was observed in the propensity-score matching analysis (adjusted hazard ratio: 1.50; 95% confidence interval: 0.99-2.29, p = 0.057). Our subgroup analysis revealed COPD to be an epiglottitis risk factor in male patients and those aged 40-64 years.

• #22 Elevated risk of acute epiglottitis in patients with chronic obstructive pulmonary disease: A nationwide cohort study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0273437

  The total epiglottitis incidence rate in the COPD cohort was higher than in the comparison cohort, with an incidence rate ratio (IRR) of 1.81 (24.0 vs. 13.4/100,000 person-years, p = 0.006) in the frequency matching and an IRR of 1.59 (23.8 vs. 15.0/100,000 person-years, p = 0.021) in the propensity-score matching. Moreover, the overall epiglottitis IRR of the COPD group was even higher at 5 years of follow-up in both frequency matching and propensity-score matching (IRR = 2.96 and 3.35, respectively). […] The results of this study suggested that COPD is a potential risk factor for epiglottitis, and the development of epiglottitis in patients with COPD may have prognostic and therapeutic implications. Overall, physicians should be mindful of the occurrence of epiglottitis in patients with COPD, particularly in men and those aged 40-64 years.

• #23 REBEL Core Cast 69.0 – Epiglottitis

  https://rebelem.com/rebel-core-cast-69-0-epiglottitis/

  Epiglottitis has demonstrated a resurgence in the adult population. It is no longer a pediatric only disease. […] Incidence of 3-5:100,000 per year. Mortality between 7-20%. […] Mean age of those affected is 55. Child:adult ratio of 0.3:1. […] Due to the success of the Hib vaccine in decreasing the incidence of pediatric illness, epiglottitis now mainly affects adults, and its initial presentation is usually more subacute. […] Epiglottitis is difficult to diagnose, and some studies have estimated that it is missed on initial presentation as much as 80% of the time.

• #24 More Than a Sore Throat: Acute Epiglottitis — Taming the SRU

  https://www.tamingthesru.com/blog/minor-care-series/more-than-a-sore-throat-acute-epiglottitis

  Not every sore throat you encounter in the emergency department is strep throat. Keeping your differential broad for the patient with sore throat can help to prevent a clinician from missing a deadly presentation of sore throat acute epiglottitis. […] The epidemiology of epiglottitis has changed significantly in the past several decades due to the introduction of the vaccination and widespread immunization of children against Haemophilus influenza type B (HIB). Although cases of pediatric acute epiglottitis have decreased, they have not disappeared. Furthermore, cases of acute epiglottitis in adults continue to persist as many have not been vaccinated against HIB and the causative agents in adults are much more diverse, with Streptococcus pneumoniae contributing to a majority of identified adult cases. […] A recent study suggests that in the post-HIB vaccination era, approximately 10.9% of cases require securing of the airway.

• #25 Epiglottitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/452

  Epiglottitis is classically described in children aged 2 to 6 years of age; however, it may manifest at any age, including in newborns. […] In countries that have introduced routine Haemophilus influenzae type B (Hib) vaccination, it is now extremely rare in children and may be more common in adults. […] Vaccination does not preclude the possibility of epiglottitis or even the possibility of epiglottitis from Haemophilus influenzae.

• #26 Epiglottitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000605.htm

  Epiglottitis is now very uncommon because the H influenzae type B (Hib) vaccine is given routinely to all children. […] In children, epiglottitis is usually caused by the bacteria Haemophilus influenzae (H influenzae) type B. In adults, it is often due to other bacteria such as Streptococcus pneumoniae, or viruses such as herpes simplex virus and varicella-zoster. […] The most common bacteria (H influenza type b) that causes epiglottitis is easily spread. If someone in your family is sick from this bacteria, other family members need to be tested and treated.

• #27 Clinical and laboratory characteristics of epiglottitis caused by Haemophilus influenzae type b in children – Sitkina – Pediatrician (St. Petersburg)

  https://journals.eco-vector.com/pediatr/article/view/109255

  Epiglottitis is a severe, life-threatening disorder being a generalized Hib infection. Patients with epiglottitis should be prescribed antibiotics prior to confirmation of Hib etiology since Hib is the causative agent of epiglottitis in the vast majority of pediatric cases. Multiple methods should be used simultaneously to confirm the diagnosis. Bacteriological blood test made it possible to identify the pathogen in the overwhelming majority of patients. There were no risk factors for Hib infection and no important comorbidity.

• #28 Prevalence of Acute Epiglottitis and its Association with Pulmonary Tuberculosis in Adults in a Tertiary Care Hospital of Nepal

  https://arquivosdeorl.org.br/additional/acervo_eng.asp?id=561

  Prevalence of Acute Epiglottitis and its Association with Pulmonary Tuberculosis in Adults in a Tertiary Care Hospital of Nepal. […] Acute epiglottitis is a rare disease which now occurs more commonly in adults. The annual prevalence of Acute Epiglottitis in adult in TUTH is 4.8 per 1000. […] This study did not find any association of acute epiglottitis with pulmonary tuberculosis. […] The epidemiology of acute epiglottitis has been changing significantly, which now occurs more commonly in adults along with a lower incidence of Haemophilus influenza involvement and in majority of patients blood culture is not helpful. […] This study did not find any evidence of pulmonary tuberculosis in the patient who had presented with acute epiglottitis.

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