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Since the introduction of the vaccine against H. influenzae, there has been a significant decrease in the number of children presenting with epiglottitis. Although there is little evidence that the disease has increased in adults, clearly the percentage of cases in adults compared to children has increased. Further, there is greater recognition of milder cases with direct visualization and imaging.

Early in my training, I was taught that adults could develop epiglottitis but that the size of their trachea made airway obstruction impossible. One very difficult intubation dealing with a very large epiglottis taught me a respect for this disorder.

Although adults with epiglottitis can develop airway obstruction, there are significant differences in the disease in adults compared to children. To paraphrase, adults are not just large children.

— Sandra M. Schneider, MD, Editor

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