Pneumococcal bacteremia secondary to acute epiglottitis is relatively rare, and all previously reported cases occurred in immunocompromised patients. We report a case of pneumococcal bacteremia associated with acute epiglottitis and retropharyngeal soft-tissue inflammation with upper airway narrowing that occurred in an otherwise healthy patient. In light of our unique finding, we recommend that pneumococcal bacteremia be suspected in an otherwise healthy patient who has systemic manifestations associated with acute epiglottitis.
References
1.
DiNubileMJ, AlbornozMA, StumacherRJ, Pneumococcal soft-tissue infections: Possible association with connective tissue diseases. J Infect Dis1991;163:897–900.
GorfinkelHJ, BrownR, KabinsSA. Acute infectious epiglottitis in adults. Ann Intern Med1969;70:289–94.
4.
BergS, TrollforsB, NylenO, Incidence, aetiology, and prognosis of acute epiglottitis in children and adults in Sweden. Scand J Infect Dis1996;28:261–4.
5.
MusherDM. Streptococcus pneumoniae. In: MandellGL, BennettJE, DolinR, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 5th ed. Philadelphia: Churchill Livingstone, 2000:2128–47.
6.
AustrianR.Some aspects of the pneumococcal carrier state. J Antimicrob Chemother1986;18(suppl A):S35–45.
7.
KimPE, MusherDM, GlezenWP, Association of invasive pneumococcal disease with season, atmospheric conditions, air pollution, and the isolation of respiratory viruses. Clin Infect Dis1996;22:100–6.
8.
BartlettJG, BreimanRF, MandellLA, FileTMJr., Community-acquired pneumonia in adults: Guidelines for management. The Infectious Diseases Society of America. Clin Infect Dis1998;26:811–38.
9.
RamirezJA. Switch therapy in adult patients with pneumonia. Clin Pulm Med1995;2:327–33.