Adult Acute Epiglottitis Caused by Serratia morcescens

Abstract

Acute epiglottitis has historically been a common disease in the pediatric population, with relatively few adult cases reported. Because of the introduction of the Haemophilus influenzae vaccine in the recent past, acute epiglottitis in children has become uncommon. In contrast, an increasing number of cases of epiglottitis in adults have been described. 1 Although the incidence in children has declined from 3.5 cases per 100,000 population per year to 0.6 cases per 100,000 per year, the adult incidence has remained relatively stable at 1.8 cases per 100,000. As in children, adult epiglottitis is manifest by dysphagia, odynophagia, and occasionally stridor progressing to airway obstruction. Although in the pediatric patients H. influenzae is the most common causative agent, the majority of adults are not culture positive for a specific pathogen. 1,2 Also, in adults, a variety of infectious agents have been identified, including pneumonococcal species and Candida, especially in immunocompromised patients. 3,4 However, to date, no cases of Serratia marcescens epiglottitis have been described. This article reports two adult immunocompromised patients with well–documented S. marcescens epiglottitis. A review of the presentation and treatment of adult patients with epiglottitis is included.