{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T06:28:35Z","timestamp":1781504915703,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study reviewed the demographics, presentation, management, complications and outcomes of acute epiglottitis post <jats:italic>Haemophilus influenzae<\/jats:italic> type\u2010b vaccine introduction in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of acute epiglottitis at four Victorian tertiary centres from 2011 to 2016 was conducted. Patient characteristics, presentation, investigations, management, complications and outcomes were recorded. Subgroup analysis aiming to identify risk factors for patients requiring acute airway management was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010seven adult and six paediatric cases were identified. The most frequent clinical findings in adults were sore throat (88.5%), dysphagia (71.3%), odynophagia (57.5%), dysphonia (56.3%) and fever (55.2%); 75.9% required intensive care unit admission. Airway compromise requiring intubation occurred in 27.6%, with 12.5% of these patients undergoing emergency surgical airways. Stridor, hypoxia, shortness of breath, odynophagia and lymphadenopathy were statistically more frequent amongst cases requiring airway intervention (<jats:italic>P<\/jats:italic> &lt; 0.05). Cultures revealed mixed results with no aetiological pattern. <jats:italic>H. influenzae<\/jats:italic> type\u2010b was never cultured. Amongst paediatric cases, fever, tachycardia and stridor were frequently observed and all were admitted to intensive care unit. Two of six required intubation and one underwent surgical intervention. There were no deaths, but one patient suffered a hypoxic brain injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Modern epiglottitis is not the disease previously encountered by clinicians. With changing demographics and varying organisms, management is adapting to reflect this. Complications are rare, and symptomatology at presentation aids earlier recognition of patients who may require airway protection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14787","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T00:18:43Z","timestamp":1536711523000},"page":"1135-1140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Review of epiglottitis in the post <i>Haemophilus influenzae<\/i> type\u2010b vaccine era"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5274-8761","authenticated-orcid":false,"given":"Samantha M.","family":"Baird","sequence":"first","affiliation":[{"name":"Department of Ear Nose and Throat\/Head and Neck Surgery Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Marsh","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Padiglione","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Trubiano","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck and Skull Base Surgery St Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hays","sequence":"additional","affiliation":[{"name":"Ear Nose and Throat Unit Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Ear Nose and Throat\/Head and Neck Surgery Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Ear Nose and Throat\/Head and Neck Surgery Austin Health  Melbourne Victoria Australia"},{"name":"Department of Otolaryngology Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Centre for Immunisation Research and Surveillance.Haemophilus influenzatype B (Hib) vaccine for Australian children. NCIRS Fact Sheet.2009. [Cited 15 Jan 2018.] Available from URL:http:\/\/www.ncirs.edu.au\/assets\/provider_resources\/fact\u2010sheets\/hib\u2010fact\u2010sheet.pdf"},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"Low incidence of children with acute epiglottis after introduction of vaccination","volume":"61","author":"Hermansen MN","year":"2014","journal-title":"Dan. Med. J."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22147"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(03)00083-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21083"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pec.0000221347.42120.f8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1258\/002221505775010823"},{"key":"e_1_2_8_9_1","unstructured":"Australian Bureau of Statistics. Regional Population Grown Australia.2016. 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