ETIOLOGY OF ACUTE EPIGLOTTITIS IN ADULTS

In order to determine the aetiology of acute epiglottitis in adults, b lood cultures, paired sera and a urine sample were obtained from 54 pa tients with fever and epiglottitis visualized by indirect laryngoscopy or bg direct fibreoptic nasolaryngoscopy. Antibodies were determined against the capsular polysaccharide of Haemophilus influenzae type b ( Hib), 3 pneumococcal antigens (a mixture of 23 capsular polysaccharide s, C-polysaccharide and pneumolysin) and antistreptolysin O. Acute ser a were examined by the polymerase chain reaction (PCR) for DNA of Hib and pneumococci, The urine samples were examined for Hib capsular anti gen, Blood cultures were positive in 15 patients. In another 16, serol ogy and/or PCR verified the aetiology, Hib was the cause in 14, pneumo cocci in 12 and group A streptococci in 5 patients. The aetiology rema ined unknown in 23/54 patients (43%), In conclusion, the addition of s erology and PCR to blood cultures doubled the possibilities of verifyi ng the aetiology of acute epiglottitis in adults.