South Dakota medicine : the journal of the South Dakota State Medical Association
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Review Case Reports
Acute epiglottitis in adults: an under-recognized and life-threatening condition.
Epiglottitis is a potentially life-threatening condition resulting from infection of the epiglottis and surrounding structures, causing classical signs and symptoms related to inflammation and progressive airway obstruction. We briefly present two recent adult cases of epiglottitis, followed by a review of the literature concerning the subject. In diagnosing epiglottitis, direct visualization by laryngoscopy is the gold standard. ⋯ Though prophylactic airway management is not necessarily indicated in the adult with epiglottitis, careful attention to the airway in a controlled intensive care environment is recommended. The severity of the clinical picture should guide the physician in his or her approach. Any clinical suspicion of epiglottitis warrants an aggressive approach until epiglottitis is ruled out or the patient is recovering well.
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Anterior screw fixation of the odontoid is contraindicated in remote type II fractures. The alternative surgical treatment consists of a posterior C1 to C2 or an occiput to C3 fusion, which is met with much resistance by patients as this option limits head motion, especially rotational movement. ⋯ To our knowledge, this is the first documented report of solid fusion of remote type II odontoid fracture treated with rhBMP-2 and anterior screw fixation. The authors believe that this technique may be a viable alternative for the treatment of failed odontoid fractures older than six months.