Sudden Death Due to Acute Epiglottitis in Adults: A Retrospective Review of 11 Postmortem Cases.

We report a retrospective review of fatal acute epiglottitis cases in adults in the province of Ontario, Canada, between 2001 and 2014. Information on demographics, clinical history, gross, microscopic, and laboratory findings were collected and analyzed. Eleven cases, predominantly male (73%), with a mean age of 50 years were identified. Common presenting symptoms included sore throat, dysphagia, and low-grade fever. The predominant postmortem findings included hyperemia and edema of the epiglottis and aryepiglottic folds. Histological features included vascular congestion, stromal edema, and acute inflammation. Five cases (45%) were positive for growth of various bacterial organisms on blood and/or tissue cultures. Acute epiglottitis should be in the differential diagnosis in fatalities presenting with symptoms of upper respiratory tract infection, followed by an episode of acute shortness of breath. History, thorough postmortem examination with close attention to the head and neck structures, histological examination of tissues, and sampling for microbiology will assist in differentiating epiglottitis from other cases of laryngeal swelling leading to death.