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July 28, 1978

Throat Swabbing in Epiglottitis

Author Affiliations

University of Texas Medical Branch Galveston

JAMA. 1978;240(4):346-347. doi:10.1001/jama.1978.03290040024010

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To the Editor.—  The management strategy for sore throat, while theoretically sound, is impracticable for busy practitioners seeing daily many patients with sore throats.It was alarming that the author suggested swabbing the epiglottis in suspected cases of acute epiglottitis. This is an extremely dangerous practice, as stimulation of the epiglottis is likely to cause acute laryngospasm and respiratory obstruction. Intubation under these circumstances is frought with difficulty and may necessitate an emergency tracheostomy for a condition that in adults can be best treated by ampicillin sodium or chloramphenicol and close observation. The need for a positive culture does not arise, as the offending organism is invariably H influenzae, and one would never consider delaying therapy until the results of a culture were available.This communication, therefore, serves to discourage the procedure of swabbing the epiglottis in suspected cases of acute epiglottitis.