PEDIATRICS Vol. 96 No. 3 September 1995, pp. 424-427
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Epiglottitis and Haemophilus influenzae Immunization: The Pittsburgh Experience–A Five-Year Review

Hugo González Valdepeña MD1, Ellen R. Wald MD2, Elizabeth Rose FRACS1, Kitirat Ungkanont MD1, and Margaretha L. Casselbrant MD, PhD1

1 Division of Pediatric Otolaryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, and Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh
2 Division of Pediatric Otolaryngology, Department of Otolaryngology, Department of Pediatric Otolaryngology, Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh

Objective. Current trends in the clinical presentation and management of children with epiglottitis at Children's Hospital of Pittsburgh were reviewed for the years 1988 to 1993.

Methodology. The medical records of all patients diagnosed as having epiglottitis between July 1988 and June 1993 at the Children's Hospital of Pittsburgh were reviewed. An additional telephone survey was conducted among the primary care physicians of those patients to collect information regarding administration of Haemophilus influenzae type b (HIB) vaccines.

Results. During the study period 28 children (age range, 11 months to 11 years, 10 months) were admitted with the diagnosis of epiglottitis. Cases declined remarkably in 1991. Fever, sore throat, and stridor were the usual symptoms. HIB was the most common cause of epiglottitis accounting for 21 cases. Candida albicans was recovered from the surface culture of the epiglottis in two patients. At least 11 children experienced vaccine failure: nine with polysaccharide vaccine and two with the conjugate vaccine for HIB.

Conclusion. Cases of epiglottitis have declined dramatically since licensure of HIB conjugate vaccines for use in early infancy. At least 52% of the reported cases represent vaccine failures with the purified polysaccharide vaccine.

Submitted on July 6, 1994
Accepted on November 22, 1994




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K Tanner, G Fitzsimmons, E D Carrol, T J Flood, and J E Clark
Lesson of the week: Haemophilus influenzae type b epiglottitis as a cause of acute upper airways obstruction in children
BMJ, November 9, 2002; 325(7372): 1099 - 1100.
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