The changing face of epiglottitis in Canterbury 1970-1996.

AIM: To record changes in the epidemiology, clinical presentation and management of the potentially fatal childhood disease, epiglottitis.

METHODS

The case records of 69 children presenting to Christchurch Hospital with acute epiglottitis over the last 27 years were reviewed to confirm the diagnosis and to record clinical data.

RESULTS

The incidence of epiglottitis increased significantly up until 1992. Since then there have been only two cases. This decline coincides with the availability of the Haemophilus influenzae Group b vaccine from 1993. Haemophilus influenzae was cultured in 86% of children. With the emergence of ampicillin resistant strains, antimicrobial therapy has changed to cephalosporins. Changes in airway management have also occurred, with the replacement of tracheostomy by elective naso-tracheal intubation.

CONCLUSIONS

The incidence of epiglottitis in New Zealand has followed trends reported overseas. The longer term implications of this declining incidence following introduction of vaccination are not known. It is important however, that doctors still know how to recognize and manage acute epiglottitis in children and adults.