amoxicillin-potassium-clavulanate-combination and Epiglottitis

A 26-year-old woman in her third trimester of pregnancy had stridor. Epiglottitis was diagnosed by fiberoptic laryngoscopy. Staphylococcus aureus was the predominant organism isolated from the laryngeal aspirate. Early intubation proved effective in managing this potentially life-threatening disease. Although pharyngitis is the most common cause of sore throat in the adult, acute epiglottitis must be considered in the differential diagnosis when there is unrelenting throat pain and minimal objective signs of pharyngitis. An early diagnosis with aggressive airway management can be life saving to both mother and fetus.

Topics: Adult; Airway Obstruction; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Therapy, Combination; Epiglottitis; Female; Humans; Intubation, Intratracheal; Pregnancy; Pregnancy Complications, Infectious; Staphylococcal Infections

During the last three years, 79 adults suffering from acute epiglottitis have been treated in the ENT departments of the university hospital Rudolf Virchow, Berlin, 36 women (41 years of age as an average) and 43 men (average age 39 years). Acute epiglottitis developed either all of a sudden, within hours, or gradually, within days. All patients complained of dysphagia and pain in the throat; dyspnea could be observed in 20%. During examination, we could see an inflamed, thickened epiglottis with edema of the arytenoid cartilages. 55 patients reported an infection of the upper airway prior to the onset of symptoms of acute epiglottitis, epiglottic abscess developed in 11 adults. The inflammation responded satisfactorily to conservative antibiotic management (broad spectrum penicillin). Only one patient had to undergo intubation, none of the adults required tracheotomy.

Topics: Acute Disease; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Deglutition Disorders; Diagnosis, Differential; Drug Therapy, Combination; Dyspnea; Epiglottitis; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged