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Steroids for airway problems in glandular fever

Introduction The proportion of patients suffering from significant airway difficulty as a complication of Infectious Mononucleosis has been put at one per cent (Johnsen et al., 1984); but there is little agreement in the literature as to the best method of managing these patients. Tracheostomy has certainly a role to play in the care of the severely affected patient and may need to be performed under local anaesthetic (Catling et al., 1984) but the condition may be fatal even when tracheostomy has been performed (Cartwright and Rucklidge, 1985). Since the 1950s there have been reports documenting the value of corticosteroids in relieving the acute symptoms and fever but there are no reports of a series of patients with oropharyngeal swelling being successfully managed with high-dose steroids. In this study we have retrospectively analysed 19 consecutive admissions to the adult ENT ward at the University Hospital, Nottingham, during the 24 months January 1984 to December 1985 with severe pharyngeal and/or laryngeal symptoms as a complication of glandular fever. This series is biased towards the severe case as the majority of sufferers are treated in the community and not seen in the ENT department.