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Acute Epiglottitis: A Personal Study over Twenty Years

At first it was thought that here was a new disease, but this idea was rapidly dispelled when search of the literature concerning epiglottitis and supraglottitis showed that several papers had been published in the USA (Sinclair 1941, Alexander et al. 1942, Du Bois & Aldrich 1943, Davis 1947), where the condition was well recognized. There was also a full analysis of 8 cases by Miller (1946), based on admissions to the Los Angeles Children's Hospital. Rabe (1948) analysed 347 cases of infectious croup admitted to hospital between 1937 and 1946, of which 28 proved to be due to epiglottitis (H. influenza, Type b). Since then much more has been written, and attention drawn to the fact that Sinclair (1941) described 10 cases of acute laryngitis with septiceemia caused by H. influenza?. It is of interest in this connexion that I have seen epiglottitis associated with meningitis. Saphir (1945) reported 5 cases of sudden death following cedema of the larynx and acute myocarditis, and McLorinan (1957, personal communication), in an account of 46 cases in Melbourne, has stressed that this organism is almost entirely responsible for the supraglottic form. In fact his statement that the diagnosis of supraglottic cedema is preferable to 'epiglottitis' may afford some explanation for the later confusion. On semantic grounds 'cedema' is not specific, whilst the suffix '-itis' is. Many other papers have since been published. The clinical picture has been described by Camps (1953) and Jones & Camps (1957), and it should be mentioned that as far back as 1950 Jones and Camps met in the post-mortem room over 2 cases within a few days of one another. Since then Jones has seen and treated many cases in his practice and the condition is well described in medicolegal textbooks (Camps 1968, 1969).