Adult Acute Epiglottitis Caused by Kiebsiella Pneumoniae: A Case Report

克雷白氏肺炎菌引起成人急性會厭炎：病例報告

楊家麟(Chia-Ling Yang) ； 侯民波(Min-Po Ho) ； 蔡光超(Kuang-Chau Tsai) ； 呂政霖(Cheng-Lin Lu) ； 趙庭寬(Ting-Kuang Chao)

《中華民國急救加護醫學會雜誌》 16卷3期 (2005/09) Pp. 129-134

https://doi.org/10.30018/JECCM.200509.0006

摘要

急性會厭炎是罕見且對生命具有威脅性的感染疾病，會造成嚴重感染且呼吸道突然阻塞導致死亡。我們遇有一位三十八歲男性病患表現急性會厭炎，病患有表現發燒，喉嚨痛，吞嚥疼痛，呼吸困難一天。C-reactive protein及白血球均升高。經確定呼吸道無礙後，照側面的頸部X光表現會厭炎。使用軟式支氣管鏡確認診斷。血液及喉嚨細茵培養均發現克雷白氏肺炎菌(Klebsiella pneumoniae)。病患接受治療包括氧氣，注射抗生素及類固醇，給予吸入式類固醇及腎上腺素。經積極治療後病患的症狀改善且無併發症，五天後平安出院。

關鍵字

成人 ； 會厭炎 ； 克雷白氏肺炎菌Klebsiella pneumoniae

並列摘要

Acute epiglottiits is a rare but potentially life-threatening infection and respiratory emergency as it may result in sudden airway obstruction and death. We present a case of acute epiglottiits in a 38 year-old man, who suffered from fever and sore throat followed by odynophagia and dyspnea for one day. There was an increased C-reactive protein and a slightly elevated white cell count. After the airway was secured, a lateral neck radiograph revealed a swollen epiglottis which was confirmed by direct visualization with a fibreotic laryngoscope. Blood and throat cultures yielded Klebsiella pneumoniae. He was given supplementary oxygen and intravenous administration of 1.5gm of ampicillin/sulbactam and 80mg of methyl-prednisolone every six hours. Inhaled 40mg of methylprednisolone and 0.5ml of adrenaline (0.5ml of 1:1000 diluted to 5ml of 0.9% saline) were also given for swollen epiglottis. His symptoms improved with aggressive treatment and he was discharged after 5 days without complications.

並列關鍵字

adult ； epiglottitis ； Klebsiella pneumoniae