Acute epiglottitis in adults: experience with fifteen cases.

Fifteen adults with acute epiglottitis are discussed. Three required tracheostomy because of delayed diagnosis. There were no deaths. Epiglottitis occurs more often in adults than is generally recognized. The early symptoms of epiglottitis in adults are sore throat and dysphagia. Any patient with acute, painful dysphagia should have indirect laryngoscopy to rule out epiglottitis. Throat and blood cultures were obtained from 14 of our cases. Cultures from only two patients were positive for Hemophilus influenzae, type B; cultures from the other 12 patients did not grow any bacterial pathogens. The primary treatment of adult epiglottitis is intravenous steroids, antibiotics, and humidified oxygen. Observation by the managing physician is mandatory during the first four hours of treatment. Tracheostomy is indicated in progressive disease.