González Valdepeña H, Wald E R, Rose E, Ungkanont K, Casselbrant M L
Department of Otolaryngology, University of Pittsburgh School of Medicine, PA, USA.
Pediatrics. 1995 Sep;96(3 Pt 1):424-7.
Current trends in the clinical presentation and management of children with epiglottitis at Children's Hospital of Pittsburgh were reviewed for the years 1988 to 1993.
The medical records of all patients diagnosed as having epiglottitis between July 1988 and June 1993 at the Children's Hospital of Pittsburgh were reviewed. An additional telephone survey was conducted among the primary care physicians of those patients to collect information regarding administration of Haemophilus influenzae type b (HIB) vaccines.
During the study period 28 children (age range, 11 months to 11 years, 10 months) were admitted with the diagnosis of epiglottitis. Cases declined remarkably in 1991. Fever, sore throat, and stridor were the usual symptoms. HIB was the most common cause of epiglottitis accounting for 21 cases. Candida albicans was recovered from the surface culture of the epiglottis in two patients. At least 11 children experienced vaccine failure: nine with polysaccharide vaccine and two with the conjugate vaccine for HIB.
Cases of epiglottitis have declined dramatically since licensure of HIB conjugate vaccines for use in early infancy. At least 52% of the reported cases represent vaccine failures with the purified polysaccharide vaccine.
回顾1988年至1993年匹兹堡儿童医院小儿会厌炎患者的临床表现及治疗的当前趋势。
回顾了1988年7月至1993年6月在匹兹堡儿童医院所有被诊断为会厌炎患者的病历。另外对这些患者的初级保健医生进行了电话调查，以收集有关b型流感嗜血杆菌（HIB）疫苗接种情况的信息。
在研究期间，28名儿童（年龄范围为11个月至11岁10个月）因会厌炎诊断入院。1991年病例显著减少。发热、咽痛和喘鸣是常见症状。HIB是会厌炎最常见的病因，占21例。两名患者的会厌表面培养物中分离出白色念珠菌。至少11名儿童出现疫苗接种失败：9名接种多糖疫苗，2名接种HIB结合疫苗。
自HIB结合疫苗在婴儿早期获批使用以来，会厌炎病例已大幅下降。报告病例中至少52%代表纯化多糖疫苗接种失败。
