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A new era in supraglottitis? An isolated UK case of supraglottitis secondary to Neisseria meningitidis

Published online by Cambridge University Press:  16 August 2011

U Sarwar ,
N Akhtar ,
J Hemming  and
S Dennis
U Sarwar*
Affiliation:
Department of Otorhinolaryngology, Salisbury District Hospital, UK
N Akhtar
Affiliation:
Department of Plastic Surgery, Nottingham City Hospital, UK
J Hemming
Affiliation:
Department of Otorhinolaryngology, Salisbury District Hospital, UK
S Dennis
Affiliation:
Department of Otorhinolaryngology, Salisbury District Hospital, UK
*
Address for correspondence: Dr U Sarwar, Department of Otorhinolaryngology, Salisbury District Hospital, Odstock Road, Salisbury SP2 8BQ, UK E-mail: u.sarwar@doctors.org.uk
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Abstract

Objective:

We report the first UK case of supraglottitis secondary to Neisseria meningitidis.

Method:

Case report with review of the current literature on supraglottitis and its aetiology.

Results:

An 89-year-old woman was referred with worsening symptoms of dysphagia, hoarseness and neck discomfort. After nasopharyngoscopy and neck X-ray, supraglottitis was diagnosed. Prompt treatment comprised nebulised adrenaline, oxygen therapy and intravenous antibiotics. Microbiology samples grew N meningitidis, a notifiable disease in the UK. Public health officials were informed, and full precautions and prophylactic treatment initiated for those at risk. The patient made excellent progress and was discharged several days later.

Discussion and conclusion:

Supraglottitis occurs in <4 per 100 000 population. Following a successful UK childhood immunisation programme, most cases occur in adults. Supraglottitis secondary to N meningitidis is exceptionally rare, with only seven other reported cases worldwide. Morbidity is exceptionally high; over 60 per cent of patients require airway intervention. To our knowledge, this is the first reported UK case of supraglottitis secondary to N meningitidis. This case highlights the important clinical, diagnostic and therapeutic interventions required to prevent complications associated with this potentially fatal condition.

Keywords

EpiglottitisLaryngitisPublic HealthNeisseria MeningitidisSupraglottitis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 11 , November 2011 , pp. 1206 - 1208
Copyright
Copyright © JLO (1984) Limited 2011

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