Epiglottitis _ epidemology and clinical presentation in kashmiri population- a retrospective study

Introduction Acute epiglottitis is an acute inflammation of the upper respiratory airway that can causes airway obstruction. Acute epiglottitis is often observed in clinical practice in the field of otolaryngology; there is a possibility of rapid airway obstruction, which may be fatal, and therefore, this disease requires a prompt and appropriate treatment. Aims and Objectives: To evaluate the clinical profile, correlation of WBC Counts on 1stday of admission with Laryngeal findings. Material and Methods: A retrospective study was conducted on patients with acute epiglottitis from January 2015 to December 2019. Results: There were 24 patients, 17 (70.83%) were males and 7 (29.17%) were females. The mean age was 35 years (range 10–70 years). 5 (20.83%) patients were diabetic .The duration of symptoms before hospitalization range from 1 to 7 days with mean was 3days. The main presenting symptoms were painful deglutition, sorethroat, fever, muffled voice and dyspnoea. Laryngeal findings on the day of admission, mildepiglottis swelling (I) was the most common in 13 patients (54.16%), followed by moderate epiglottis swelling (II) in 7 patients (29.16%), and severe epiglottic swelling (III) in 4 patients (16.66%). Hospitalization duration was 4 to 15 days (mean of 8 days). Hematological examinations were performed on the first and fifth day of hospitalization. The mean number of white blood cells (WBC) counts on the first day were 16239/μL (12580 to 22650/μL) and the mean number of WBC counts on the fifth day were 5548/μL (2,000–15,000/μL) and there was a significant decrease compared to the day of admission p < 0.05 Conclusions: Acute epiglottis is a rear but life threatening condition which can be treated well with timely diagnosis and adequate treatment by antibiotics and steroids. WBC counts on the first day of admission was statistically seen to be co-related very well with severaity of disease and patients with WBC counts ≥ 20,000/µl on the day of admission needs critical care monitoring to avoid respiratory compromise. We have reported that (1)upper airway obstructive symptoms during the initial visit, (2) airway obstructive symptoms within 1 day from onset and (3) Katori and Tsukuda's classification III (4) WBC count ≥ 20,000/µl at the time of admission are the indicators for airway management