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  • Print publication year: 2008
  • Online publication date: December 2009

8 - Supraglottitis

from Part I - Systems
    • By Theresa A. Gurney, Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA, Andrew H. Murr, Professor of Clinical Otolaryngology–Head and Neck Surgery, University of California, San Francisco School of Medicine, Chief of Service San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Publisher: Cambridge University Press
  • DOI: https://doi.org/10.1017/CBO9780511547454.009
  • pp 43-44

Summary

INTRODUCTION – AGENTS

Patients with supraglottitis may present to the acute care setting with complaints of a sore throat and difficulty breathing. These symptoms may reflect a self-limited upper respiratory infection (URI) or, infrequently, an impending airway emergency.

Supraglottitis describes inflammation of the supraglottic structures, which include the epiglottis, the false vocal cords and arytenoids, and the aryepiglottic folds. In the past these infections were all called epiglottitis, but supraglottitis is a more anatomically accurate description as the surrounding supraglottic structures are usually involved. The vallecula and tongue base, technically part of the oropharynx, may also be affected.

Haemophilus influenzae was previously the primary organism responsible for epiglottitis/supraglottitis. With the advent of the H. influenzae type B (HIB) vaccine and its widespread use, the overall incidence of supraglottitis and H. influenza as a causative organism has decreased significantly. Other causative etiologies include Streptococcus pneumoniae, Streptococcus pyogenes Staphylococcus species, and other Haemophilus species, such as Haemophilus parainfluenzae. Less commonly involved are bacteria such as Klebsiella or Pseudomonas, viruses, or Candida.

EPIDEMIOLOGY

In the past, young children made up the majority of cases of epiglottitis (see Chapter 49, Pediatric Respiratory Infections). With widespread HIB vaccination of the pediatric population, however, the disease is now more common in adults than children in the United States.

REFERENCES
Cantrell, R W, Bell, R A, Morioka, W T. Acute epiglottitis: intubation versus tracheostomy. Laryngoscope 1978;88(6):994–1005.
Fairbanks, D N F. Pocket guide to antimicrobial therapy in otolaryngology – head and neck surgery, 12th ed. Washington, DC: American Academy of Otolaryngology, 2005.
Osborne, R, Avitia, S, Zandifar, H, Brown, J.Adult supraglottitis subsequent to smoking crack cocaine. Ear Nose Throat J 2003;82(1):53–5.
Rodgers, G K, Galos, R S, Johnson, J T. Hereditary angioedema: case report and review of management. Otolaryngol Head Neck Surg 1991;104(3):394–8.