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病例报告:新型冠状病毒肺炎背景下的会厌炎

Case report: Epiglottitis in the setting of COVID-19.

作者信息

Smith Connor, Mobarakai Olivia, Sahra Syeda, Twito Joshua, Mobarakai Neville

机构信息

Touro College of Medicine, NY, USA.

Staten Island University Hospital, Staten Island, NY, USA.

出版信息

IDCases. 2021;24:e01116. doi: 10.1016/j.idcr.2021.e01116. Epub 2021 Apr 7.

Abstract

Epiglottitis is an uncommon, potentially fatal infection of the epiglottis that can lead to complete upper airway obstruction. Isolated pathogens are usually nasopharyngeal bacteria, most commonly type b (Hib). While the incidence of epiglottitis has diminished significantly over the years due to widespread vaccination against Hib, the proportion of epiglottitis caused by other pathogens has increased. In this report, we introduce an unseen presentation of acute epiglottitis associated with severe acute respiratory distress syndrome--coronavirus2 (SARS-CoV-2), who presented to the emergency department with throat pain and odynophagia that quickly resulted in respiratory distress. Clinicians should be aware of airway edema's concomitant presence in patients with acute epiglottitis and COVID-19 and maintain a low threshold for intubation. The rapidly progressive nature of COVID-19 and its complications may preclude intubation later on in the patient's clinical course, potentially necessitating an emergent surgical airway.

摘要

会厌炎是一种罕见的、可能致命的会厌感染,可导致完全性上呼吸道梗阻。分离出的病原体通常为鼻咽部细菌,最常见的是b型流感嗜血杆菌(Hib)。尽管近年来由于广泛接种Hib疫苗,会厌炎的发病率已显著下降,但由其他病原体引起的会厌炎比例有所增加。在本报告中,我们介绍了一例与严重急性呼吸窘迫综合征冠状病毒2(SARS-CoV-2)相关的急性会厌炎的罕见病例,该患者因咽痛和吞咽痛就诊于急诊科,很快就出现了呼吸窘迫。临床医生应意识到急性会厌炎患者与新型冠状病毒肺炎(COVID-19)患者同时存在气道水肿,并保持较低的插管阈值。COVID-19及其并发症的快速进展特性可能会使患者在临床病程后期无法进行插管,可能需要紧急建立外科气道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1e/8065280/31f438ae537a/gr1.jpg

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