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成人会厌炎的管理:一项综合病例研究。

Managing Epiglottitis in Adults: A Comprehensive Case Study.

作者信息

McDermott Jamie, Sadeghi Nima, Anasi Ayman, Mayer Brian, Ahmed Imtiaz

机构信息

Medicine, Midwestern University Arizona College of Osteopathic Medicine, Glendale, USA.

Radiology, Tempe St. Luke's Hospital, Tempe, USA.

出版信息

Cureus. 2024 Nov 10;16(11):e73387. doi: 10.7759/cureus.73387. eCollection 2024 Nov.

Abstract

Epiglottitis is an inflammatory condition involving the epiglottis and surrounding tissues. While it can develop at any age, it was traditionally more common in children, largely due to infections with type B (Hib). Since the introduction of the Hib vaccine, the incidence in children has significantly decreased, while cases in adults have become more prevalent. We present here the case of a 44-year-old male who presented to the emergency department with a one-day history of throat pain. He reported throat discomfort and pain exacerbated by swallowing and phonation that began one day prior after taking a dose of azithromycin. X-ray and CT imaging revealed inflammation and swelling of the epiglottis (thumbprint sign) with near-complete airway obstruction. Despite the absence of severe respiratory distress, the patient was intubated, differing from recommendations in previous studies. This case emphasizes the importance of developing standardized treatment protocols for acute epiglottitis in adults, particularly regarding airway management and minimizing unnecessary imaging.

摘要

会厌炎是一种累及会厌及周围组织的炎症性疾病。虽然它可在任何年龄发病,但传统上在儿童中更为常见,这主要是由于感染B型流感嗜血杆菌(Hib)所致。自从引入Hib疫苗后,儿童中的发病率显著下降,而成人病例则变得更为普遍。我们在此介绍一例44岁男性患者,他因咽痛一天就诊于急诊科。他报告称,在服用一剂阿奇霉素一天后开始出现吞咽和发声时加重的咽喉不适和疼痛。X线和CT成像显示会厌炎症和肿胀(拇指印征),伴有近乎完全的气道阻塞。尽管没有严重的呼吸窘迫,但该患者仍接受了插管,这与先前研究中的建议不同。该病例强调了制定成人急性会厌炎标准化治疗方案的重要性,特别是在气道管理和尽量减少不必要的成像方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6f/11630618/b7b6fb41a372/cureus-0016-00000073387-i01.jpg

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