• U Sarwar, N Akhtar, J Hemming, and S Dennis.
• Department of Otorhinolaryngology, Salisbury District Hospital, UK. u.sarwar@doctors.org.uk
• J Laryngol Otol. 2011 Nov 1; 125 (11): 1206-8.

ObjectiveWe report the first UK case of supraglottitis secondary to Neisseria meningitidis.MethodCase report with review of the current literature on supraglottitis and its aetiology.ResultsAn 89-year-old woman was referred with worsening symptoms of dysphagia, hoarseness and neck discomfort. After nasopharyngoscopy and neck X-ray, supraglottitis was diagnosed. Prompt treatment comprised nebulised adrenaline, oxygen therapy and intravenous antibiotics. Microbiology samples grew N meningitidis, a notifiable disease in the UK. Public health officials were informed, and full precautions and prophylactic treatment initiated for those at risk. The patient made excellent progress and was discharged several days later.Discussion And ConclusionSupraglottitis occurs in <4 per 100 000 population. Following a successful UK childhood immunisation programme, most cases occur in adults. Supraglottitis secondary to N meningitidis is exceptionally rare, with only seven other reported cases worldwide. Morbidity is exceptionally high; over 60 per cent of patients require airway intervention. To our knowledge, this is the first reported UK case of supraglottitis secondary to N meningitidis. This case highlights the important clinical, diagnostic and therapeutic interventions required to prevent complications associated with this potentially fatal condition.

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