RESUMO
Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the Haemophilus influenzae type B vaccination and is more recently caused by Streptococcus pneumoniae, S. pyogenes, H. influenzae non-type B, H. parainfluenzae, Staphylococcus aureus and Pasteurella multocida Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. During his admission, the patient was critically unwell and required surgical intervention and tracheostomy. However, he made a full recovery with no persisting morbidity. We believe that this was owed to the aggressive antimicrobial therapy, timely surgical management of the disease process and the patientâ™s immunocompetency.
Assuntos
Antibacterianos/uso terapêutico , Infecções por Haemophilus/microbiologia , Influenza Humana/microbiologia , Necrose/microbiologia , Oseltamivir/uso terapêutico , Penicilina G/uso terapêutico , Supraglotite/microbiologia , Traqueostomia , Adulto , Estado Terminal , Desbridamento , Enterococcus faecalis/isolamento & purificação , Infecções por Haemophilus/complicações , Infecções por Haemophilus/imunologia , Haemophilus influenzae tipo b/isolamento & purificação , Humanos , Imunocompetência/imunologia , Vírus da Influenza A/isolamento & purificação , Influenza Humana/complicações , Influenza Humana/imunologia , Masculino , Necrose/imunologia , Necrose/patologia , Necrose/terapia , Supraglotite/imunologia , Supraglotite/patologia , Supraglotite/terapia , Resultado do TratamentoRESUMO
Acute supraglottitis is a medical emergency as it can rapidly lead to airway compromise. With routine pediatric immunization for Hemophilus influenzae serotype b, supraglottitis is now more prevalent in adults, with a shift in the causative organisms and a change in the natural history of this disease. Here, we present a case of supraglottitis due to group B streptococcus that occurred in an adult with previously undetected immunoglobulin 4 (IgG4) and complement protein C2 deficiency.