Laryngeal Infection: Supraglottitis

Epidemiology

Laryngitis specifically refers to inflammation of the laryngeal mucosa and vocal cords resulting in hoarseness. Supraglottitis can be considered an adult form of epiglottitis. It indicates diffuse swelling of the supraglottis that is indicative of a much more severe condition than laryngitis and may be life threatening. In addition to the larynx, the disease involves the valleculae, uvula, base of the tongue, soft palate, and prevertebral soft tissues. The incidence of supraglottitis is 1.8 cases per 1 million adults. However, this may underestimate the true prevalence of this disease because endoscopy is necessary to confirm it. Supraglottitis is associated with acquired immune deficiency syndrome.

Clinical Findings

The most common presenting symptoms include fever, sore throat, and dysphagia. Other symptoms include odynophagia, stridor, muffled voice, and drooling. The course of the disease is more indolent in adults than in children. In the majority of adults, the symptoms do not result in airway obstruction. This may be due to the larger diameter and greater rigidity of the adult airway.

Pathology

The organisms that are believed to cause supraglottitis include Haemophilus influenzae, group A, and group F beta-hemolytic Streptococcus pyogenes and Staphylococcus aureus.

Treatment