Abstract
Acute epiglottitis is an acute inflammation of the upper respiratory airway that rarely
causes airway obstruction. A retrospective study was conducted on 115 patients with
acute epiglottitis from April 2007 to December 2017 (65 males and 50 females; aged
12–85 years old, median age of 45 years). When counting the number of patients according
to the month, from April to September more than 10 patients were treated. Median duration
from symptom onset to first visit was 3 days (1–14 days). Eight (7%) of 115 patients
had diabetes, and 16 (13.9%) had epiglottic cyst. We divided all the patients into
six groups by laryngeal findings according to the classification of Katori and Tsukuda.
Number of patients classified as IA, IB, IIA, IIB, IIIA, and IIIB was 41 (35.7%),
21 (18.3%), 22 (19.1%), 15 (13%), 8 (7%), and 8 (7%), respectively. Median duration
of hospitalization was 5 days (2–26 days). In the blood test on the first day of hospitalization,
the number of white blood cells (WBC) ranged from 3,400 to 25,350/μL (median 10,350/μL)
and the C-reactive protein (CRP) ranged from 0.01 to 23.3 mg/dL (median, 2.5 mg/dL).
The number of WBC and CRP at the fourth day after the hospitalization was significantly
lower than those at the first day. Eight (7%) patients required the airway management
such as tracheotomy or cricothyroidotomy. Age, laryngeal finding (severe epiglottis
swelling and arytenoid edema; Katori and Tsukuda's classification IIIB), and high
inflammatory reaction in blood test (WBC ≥ 20,000/μL and CRP ≥ 20 mg/dL) were the
factors that significantly correlated with the airway management.
Keywords
acute epiglottitis - airway management - laryngeal finding - inflammatory reaction
in blood test - tracheotomy
