Lindquist Benjamin, Zachariah Sybil, Kulkarni Anita
Former Emergency Medicine Resident in the Stanford/Kaiser Emergency Medicine Residency Program in Stanford, CA.
Emergency Medicine Resident in the Stanford/Kaiser Emergency Medicine Residency Program in Stanford, CA.
Perm J. 2017;21:16-089. doi: 10.7812/TPP/16-089.
Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis.
We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis. Three of the patients improved with conservative measures and were observed in the intensive care unit. One patient required an emergent tracheostomy.
This series of patients is unique in that all four patients presented to a single Emergency Department within a few days of each other and, despite a myriad of presenting chief complaints, the patients were eventually found to have the same potentially life-threatening diagnosis.These cases reinforce the variability of presenting symptoms and physical examination findings that can occur in patients with epiglottitis. They also highlight clinical findings and adjunctive testing that can help identify patients who would most benefit from intervention.
在冬季,急诊科会涌入大量患有呼吸道疾病的患者。急诊医生需要在大量患有轻度上呼吸道疾病的患者中迅速识别出重症患者。急性会厌炎就是这些危及生命的病症之一。
我们报告了一系列罕见的病例,2015年4月的一周内,有四名成年患者前来我们急诊科就诊,最终被诊断为急性会厌炎。其中三名患者通过保守治疗病情好转,并在重症监护病房接受观察。一名患者需要紧急气管切开术。
这一系列患者的独特之处在于,所有四名患者在几天内相继就诊于同一个急诊科,尽管他们有各种各样的主要就诊主诉,但最终都被发现患有相同的潜在危及生命的诊断。这些病例强化了会厌炎患者出现症状和体格检查结果的变异性。它们还突出了有助于识别最能从干预中获益的患者的临床发现和辅助检查。