Acute epiglottitis in Iceland 1983-2005

• Published in: Auris Nasus Larynx
• Main Authors: Briem, Birgir, Thorvardsson, Ornolfur, Petersen, Hannes
• Other Authors: Department of Otolaryngology, Buskerud Central Hospital, Dronninggata 28, 3004 Drammen, Norway. [e-mail]
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier Science 2009
• Subjects: Acute Disease; Adolescent; Adult; Age Distribution; Aged; 80 and over; Anti-Bacterial Agents; Child; Preschool; Epiglottitis; Female; Haemophilus Vaccines; Haemophilus influenzae type b; Humans; Iceland; Incidence; Infant; Intensive Care Units; Intubation; Intratracheal; Length of Stay; Male; Middle Aged; Retrospective Studies; Seasons; Sex Distribution; Streptococcus; Tracheotomy; Young Adult
• Online Access: http://hdl.handle.net/2336/74395; https://doi.org/10.1016/j.anl.2008.03.012

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field OBJECTIVE: To describe the changes in the epidemiology of epiglottitis in Iceland from 1983 to 2005. METHODS: All patients with the discharge diagnosis of epiglottitis during the study years were identified and diagnosis confirmed by chart review. Main outcome measures were age, gender, month/year of diagnosis, microbiology, airway management, ICU admissions, choice of antibiotics, length of hospital stay and major complications/mortality. RESULTS: Fifty-seven patients were identified (annual incidence 0.93/100.000). The mean age was 33.3 years (1-82). Childhood epiglottitis disappeared after introduction of Haemophilus influenzae type b (Hib) vaccination in 1989 but adult disease showed non-significant increase. In the pre-vaccination era Hib was the most common organism cultured but it has not been diagnosed in Iceland since 1991 and Streptococci are now the leading cause of epiglottitis. The mean hospital stay was 5.05 nights with 51% of patients admitted to ICU. All children under 10 years and a total 30% of patients received airway intervention. Ninety percent of adults were observed without airway intervention. Major complications were rare and mortality was 0% in our series. CONCLUSION: There have been major changes in the epidemiology of epiglottitis in Iceland during the study period. Previously a childhood disease, epiglottitis has disappeared in children and is now almost exclusively found in adults. This can be attributed to widespread Hib vaccination, eliminating the major causative agent in children. The treatment of this life-threatening disease remains a challenge. Our series suggest that it is safe to observe patients with mild/moderate symptoms without airway intervention.