EPIGLOTTITIS IN ADULTS AND CHILDREN IN OLMSTED COUNTY, MINNESOTA, 1976 THROUGH 1990

Objective: To compare the initial clinical manifestations and sequelae of epiglottitis among children and adult residents of Olmsted County, Minnesota, Material and Methods: We conducted a population-based retr ospective cohort study of all Olmsted County residents with the diagno sis of epiglottitis during the 15-year period from Jan, 1, 1976, throu gh Dec, 31, 1990, Results: From 1976 through 1990, 41 residents (20 ch ildren and 21 adults) of Olmsted County were diagnosed with epiglottit is, (One case in an adult was first diagnosed at autopsy and was inclu ded only in the incidence rates and analysis of seasonal and secular t rends.) Children had a mean annual incidence rate of 4.25 per 100,000, whereas the rate in adults was 2.18 per 100,000, The age- and sex-adj usted incidence of epiglottitis decreased during the study period from 4.94 per 100,000 during 1976 through 1980 to 2.08 per 100,000 during 1986 through 1990, No seasonal effect was detected in adults or childr en, At initial assessment, adults tended to have pharyngeal symptoms ( sore throat and odynophagia), cervical adenopathy, and ear pain, where as children most often had respiratory (strider, dyspnea, and retracti ons) and laryngeal symptoms, Proportionately, more children than adult s received artificial airway support and had associated pneumonia, One death occurred in an adult, in whom the diagnosis was made at autopsy , Conclusion: The incidence of epiglottitis has decreased significantl y in recent years, Children and adults have considerably different ini tial manifestations of epiglottitis.