Acute epiglottis: a case cluster.

Acute epiglottitis is most commonly recognised in children as an infection with H. influenzae and may be a severe and rapidly fatal disease. Less commonly, adults, compromised by chronic bronchitis, may develop acute epiglottitis with H. influenzae or with a variety of other organisms including Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, ' beta haemolytic group C Streptococci 2 or Klebsiella Spp.3 The peak incidence in children is 2 6 years of age, due to the fact that infants receive passive immunity to H. influenzae in utero which decreases after birth. Susceptibility to infection then increases until a natural immunity to the micro -organism is developed later in childhood. There may be a seasonal predominance in the winter months. The main focus of infection is the supraglottic area, but the acute phase of the infection is more generalised, producing a state of toxaemia. The presentation is usually of sudden onset with dyspnoea, stridor, and profuse drooling. The severity of the infection usually requires immediate medical attention. Prompt treatment is directed towards relief of any airway obstruction and the eradication of the aetiological agent by the use of appropriate antibiotics.