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成人会厌炎是一种常被忽视的、危及生命的疾病,需要特殊气道处理;病例报告

Adult Epiglottitis as an Often Overlooked, Life-threatening Condition Requiring Special Airway Consideration; a Case Report.

作者信息

Ramawad Hamzah Adel, Seatherton Robert, Chineme Jessica

机构信息

Department of Emergency Medicine, NYC Health & Hospital, South Brooklyn Health, Brooklyn, New York, USA.

出版信息

Arch Acad Emerg Med. 2024 Sep 11;12(1):e69. doi: 10.22037/aaem.v12i1.2351. eCollection 2024.

Abstract

After the implementation of vaccination against Haemophilus Influenza Type B (Hib), adult patients comprise the majority of patients with acute epiglottitis. Its presentation with stridor mandates swift recognition and intervention to prevent airway compromise and mortality. Here, we present a case of a 44-year-old male with diabetes mellitus who presented with acute onset of shortness of breath and stridor following days of throat soreness and fever. Initial treatment for suspected anaphylaxis provided partial relief, and emergency department evaluation revealed characteristic signs of acute epiglottitis on lateral soft tissue neck x-ray and nasopharyngoscopy. Treatment was initiated with intravenous ampicillin/sulbactam and dexamethasone, and the patient was discharged home on day 4. This case underscores the critical importance of maintaining a high index of suspicion for acute epiglottitis in adults presenting with stridor and respiratory distress. Prompt recognition, airway management, and appropriate antibiotic therapy are paramount in mitigating the potentially devastating outcomes associated with this condition. As demographics shift and vaccination impacts epidemiology, heightened vigilance in emergency settings is essential to improve outcomes in adult patients with acute epiglottitis.

摘要

在实施乙型流感嗜血杆菌(Hib)疫苗接种后,成年患者占急性会厌炎患者的大多数。其伴有喘鸣的表现要求迅速识别并干预,以防止气道阻塞和死亡。在此,我们报告一例44岁患有糖尿病的男性患者,在数天的咽痛和发热后,出现急性呼吸急促和喘鸣。对疑似过敏反应的初始治疗提供了部分缓解,急诊科评估在颈部侧位软组织X线片和鼻咽喉镜检查中发现了急性会厌炎的特征性体征。开始静脉注射氨苄西林/舒巴坦和地塞米松治疗,患者于第4天出院。该病例强调了对于出现喘鸣和呼吸窘迫的成年患者,高度怀疑急性会厌炎的至关重要性。及时识别、气道管理和适当的抗生素治疗对于减轻与该疾病相关的潜在灾难性后果至关重要。随着人口结构的变化和疫苗接种对流行病学的影响,在紧急情况下提高警惕对于改善成年急性会厌炎患者的治疗结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/963c/11408896/65fdc701fb03/aaem-12-e69-g001.jpg

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