Acute Epiglottitis as a Fetal Complication in Patients Affected with Influenza

DOI Web Site 13 References
  • Kishine Naomi
    Department of Otolaryngology, Tsuchiura Kyodo General Hospital
  • Kawashima Yoshiyuki
    Department of Otolaryngology, Tsuchiura Kyodo General Hospital Department of Otolaryngology, Tokyo Medical and Dental University
  • Mizushima Kota
    Department of Otolaryngology, Tsuchiura Kyodo General Hospital
  • Takeda Takamori
    Department of Otolaryngology, Tsuchiura Kyodo General Hospital
  • Kamada Tomoko
    Department of Otolaryngology, Tsuchiura Kyodo General Hospital
  • Ito Taku
    Department of Otolaryngology, Tsuchiura Kyodo General Hospital
  • Kitamura Ken
    Department of Otolaryngology, Tokyo Medical and Dental University

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Other Title
  • インフルエンザ罹患後に発症した喉頭蓋膿瘍の3例
  • 症例 インフルエンザ罹患後に発症した喉頭蓋膿瘍の3例
  • ショウレイ インフルエンザリカンゴ ニ ハッショウ シタ コウトウブタ ノウヨウ ノ 3レイ

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Abstract

It has been reported that fatal complications associated with influenza include unexpected cardiopulmonary arrest as well as pneumonia, encephalitis and myocarditis. Here we report three cases with life-threatening epiglottic abscess that developed shortly after diagnosis of influenza. Case 1: A 45-year-old male visited a primary-care physician with a sore throat and was diagnosed with influenza B using a throat swab. A few hours later, breathing became difficult and he called for an ambulance. An emergency medical team found him in cardiopulmonary arrest at home. Case 2: A 62-year-old male with fever and dysphagia was diagnosed as influenza A and administered the neuraminidase inhibitor zanamivir. Breathing difficulties appeared several hours later, during the night. Case 3: A 53-year-old female with a sore throat was diagnosed as influenza B and administered the inhaled neuraminidase inhibitor laninamivir octanoate. The sore throat was resolved after several days but dyspnea reappeared four days after the diagnosis of influenza. In all three cases, flexible fiberscopy revealed a swollen epiglottis with an abscess that had almost completely closed the upper respiratory tract. We believe that acute epiglottitis can be a fatal complication in patients infected with influenza virus. It is recommended to assess the presence or absence of signs and symptoms of airway constriction in physical examination of patients with influenza. It is also important to give instruction to patients to return to the clinic if respiratory distress develops.

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