Sarwar U, Akhtar N, Hemming J, Dennis S
Department of Otorhinolaryngology, Salisbury District Hospital, UK.
J Laryngol Otol. 2011 Nov;125(11):1206-8. doi: 10.1017/S0022215111002027. Epub 2011 Aug 16.
We report the first UK case of supraglottitis secondary to Neisseria meningitidis.
Case report with review of the current literature on supraglottitis and its aetiology.
An 89-year-old woman was referred with worsening symptoms of dysphagia, hoarseness and neck discomfort. After nasopharyngoscopy and neck X-ray, supraglottitis was diagnosed. Prompt treatment comprised nebulised adrenaline, oxygen therapy and intravenous antibiotics. Microbiology samples grew N meningitidis, a notifiable disease in the UK. Public health officials were informed, and full precautions and prophylactic treatment initiated for those at risk. The patient made excellent progress and was discharged several days later.
Supraglottitis occurs in <4 per 100 000 population. Following a successful UK childhood immunisation programme, most cases occur in adults. Supraglottitis secondary to N meningitidis is exceptionally rare, with only seven other reported cases worldwide. Morbidity is exceptionally high; over 60 per cent of patients require airway intervention. To our knowledge, this is the first reported UK case of supraglottitis secondary to N meningitidis. This case highlights the important clinical, diagnostic and therapeutic interventions required to prevent complications associated with this potentially fatal condition.
我们报告英国首例由脑膜炎奈瑟菌引起的会厌炎病例。
病例报告，并对当前有关会厌炎及其病因的文献进行综述。
一名89岁女性因吞咽困难、声音嘶哑和颈部不适症状加重前来就诊。经鼻咽镜检查和颈部X线检查后，确诊为会厌炎。迅速给予雾化肾上腺素、氧疗和静脉抗生素治疗。微生物样本培养出脑膜炎奈瑟菌，这在英国属于须通报的疾病。已通知公共卫生官员，并对有风险的人员采取了全面预防措施和预防性治疗。患者恢复良好，数日后出院。
会厌炎的发病率为每10万人中不足4例。在英国儿童免疫计划取得成功后，大多数病例发生在成年人中。由脑膜炎奈瑟菌引起的会厌炎极为罕见，全球仅另有7例报告病例。发病率极高；超过60%的患者需要进行气道干预。据我们所知，这是英国首例报告的由脑膜炎奈瑟菌引起的会厌炎病例。该病例凸显了预防与这种潜在致命疾病相关并发症所需的重要临床、诊断和治疗干预措施。
