What is epiglottitis and how does it affect breathing. What are the main causes of epiglottitis in children and adults. How is epiglottitis diagnosed and treated. What are the potential complications of untreated epiglottitis. How can epiglottitis be prevented through vaccination and other measures.

Understanding Epiglottitis: A Potentially Fatal Throat Condition

Epiglottitis is a serious medical condition characterized by inflammation and swelling of the epiglottis, a small flap of tissue at the base of the tongue. This crucial structure normally prevents food and liquids from entering the windpipe during swallowing. When the epiglottis becomes inflamed, it can obstruct the airway, making breathing difficult or even impossible.

Is epiglottitis a medical emergency? Absolutely. If left untreated, epiglottitis can rapidly progress to complete airway blockage, potentially leading to suffocation and death. The severity of this condition necessitates immediate medical attention and intervention.

The Historical Context and Changing Landscape of Epiglottitis

Epiglottitis has a rich historical background, with its first accurate description attributed to Andrew Lemierre in 1936. Interestingly, some historians speculate that George Washington’s death in 1796, previously attributed to quinsy (peritonsillar abscess), may have actually been due to epiglottitis.

In the past, epiglottitis was more prevalent in children than adults, primarily due to the smaller diameter of children’s epiglottic openings. However, the landscape of this condition has changed significantly over the years. How has the incidence of epiglottitis evolved? The introduction of widespread vaccination against Haemophilus influenzae type b (Hib) in 1985 has dramatically reduced the occurrence of epiglottitis in children. Today, the conservative estimate of epiglottitis incidence is approximately 1 case per 100,000 people annually in the United States.

Causes and Risk Factors of Epiglottitis

Epiglottitis can be triggered by various factors, with bacterial, fungal, and viral infections being the most common causes, especially among adults. The primary infectious agents include:

• Haemophilus influenzae
• Streptococcus pneumoniae
• Other streptococcus species
• Respiratory tract viruses

Individuals with compromised immune systems face a higher risk of developing epiglottitis. Are there non-infectious causes of epiglottitis? Yes, thermal epiglottitis can occur from consuming extremely hot liquids or solids, or from inhaling hot substances such as the tips of marijuana cigarettes or metal pieces from crack cocaine pipes.

Unusual causes of epiglottitis include:

• Brown recluse spider bites to the ear
• Allergic-like reactions to consuming buffalo fish
• Blunt trauma to the throat
• Foreign objects obstructing the throat

Recognizing the Symptoms of Epiglottitis

Epiglottitis can progress rapidly, with symptoms developing within hours to a few days. The presentation of symptoms may differ between children and adults.

Symptoms in Children

Children often experience a swift onset of symptoms, typically within hours. These may include:

• Sudden, severe sore throat
• High fever
• Stridor (a high-pitched whistling sound when breathing in)
• Muffled or changed voice
• Drooling
• Absence of cough
• Anxiety or restlessness
• Leaning forward while seated
• Keeping the mouth open
• Difficulty speaking
• Troubled breathing
• Cyanosis (bluish skin color due to lack of oxygen)

Symptoms in Adults and Older Children

In adults and older children, symptoms often develop more gradually over a few days. These may include:

• Severe sore throat
• Fever
• Hoarse or muffled voice
• Stridor
• Pain or difficulty swallowing
• Drooling
• Irritability or restlessness

Diagnosing Epiglottitis: A Delicate Process

Diagnosing epiglottitis requires a careful and cautious approach due to the risk of precipitating complete airway obstruction. How do medical professionals diagnose epiglottitis? The process typically involves:

1. Clinical evaluation: Observing symptoms and physical signs
2. Lateral neck X-ray: To visualize the swollen epiglottis (known as the “thumb sign”)
3. Laryngoscopy: Direct visualization of the epiglottis, performed only in a controlled setting
4. Blood tests: To check for signs of infection and inflammation
5. Throat cultures: To identify the specific pathogen causing the infection

It’s crucial to note that attempts to examine the throat of a person suspected of having epiglottitis should only be made by trained medical professionals in a setting where immediate airway management is possible.

Treatment Approaches for Epiglottitis

The treatment of epiglottitis focuses on securing the airway and addressing the underlying cause. What are the primary components of epiglottitis treatment?

1. Airway management: This may involve intubation or, in severe cases, tracheostomy
2. Antibiotics: To combat bacterial infections
3. Corticosteroids: To reduce inflammation and swelling
4. Fluid management: To prevent dehydration
5. Pain relief: To manage discomfort and promote rest
6. Close monitoring: In an intensive care setting until the condition stabilizes

The choice of antibiotics may be adjusted based on culture results and local antibiotic resistance patterns. In cases of viral epiglottitis, supportive care is the mainstay of treatment.

Complications and Long-Term Outlook of Epiglottitis

If not promptly treated, epiglottitis can lead to severe complications. What are the potential consequences of untreated epiglottitis?

• Complete airway obstruction
• Respiratory failure
• Hypoxic brain injury
• Epiglottic abscess formation
• Sepsis
• Death

With timely and appropriate treatment, most patients with epiglottitis recover fully. However, the condition can recur in some cases, especially in individuals with underlying health issues or compromised immune systems.

Prevention Strategies: Vaccination and Beyond

Prevention of epiglottitis primarily focuses on vaccination against Haemophilus influenzae type b (Hib), which has dramatically reduced the incidence of this condition in children. What other measures can help prevent epiglottitis?

• Maintaining good hygiene practices
• Avoiding exposure to secondhand smoke
• Practicing caution when consuming very hot foods or liquids
• Seeking prompt treatment for upper respiratory infections
• Managing underlying health conditions that may compromise the immune system

For individuals at high risk, such as those with compromised immune systems, additional preventive measures may be recommended by healthcare providers.

Epiglottitis in Special Populations

While epiglottitis can affect anyone, certain populations may be at higher risk or experience unique challenges. How does epiglottitis manifest in different groups?

Epiglottitis in Infants

Epiglottitis in children under one year of age is relatively uncommon. When it does occur, it can be particularly challenging to diagnose due to the non-specific nature of symptoms in this age group. Infants with epiglottitis may present with:

• Irritability
• Poor feeding
• Drooling
• Respiratory distress

Epiglottitis in Immunocompromised Individuals

People with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or taking immunosuppressive medications, are at increased risk of developing epiglottitis. In these individuals, the condition may:

• Progress more rapidly
• Be caused by opportunistic pathogens
• Require more aggressive treatment
• Have a higher risk of complications

Epiglottitis in the Elderly

Older adults may experience a more insidious onset of epiglottitis symptoms. The condition in this population can be complicated by:

• Comorbid health conditions
• Decreased immune function
• Altered pain perception
• Cognitive impairment affecting symptom reporting

Emerging Research and Future Directions in Epiglottitis Management

As medical knowledge advances, new approaches to diagnosing and treating epiglottitis are being explored. What are some areas of ongoing research in epiglottitis management?

• Development of rapid diagnostic tests for faster identification of causative pathogens
• Exploration of non-invasive airway management techniques
• Investigation of novel anti-inflammatory agents to reduce epiglottic swelling
• Study of long-term outcomes in epiglottitis survivors
• Research into potential genetic factors influencing susceptibility to epiglottitis

These research efforts aim to improve outcomes, reduce complications, and enhance our understanding of this potentially life-threatening condition.

The Role of Public Awareness in Epiglottitis Prevention and Management

Raising public awareness about epiglottitis is crucial for early recognition and prompt treatment of this condition. How can increased awareness contribute to better outcomes?

• Encouraging timely vaccination against Hib and other causative pathogens
• Promoting recognition of early warning signs, particularly in children
• Emphasizing the importance of seeking immediate medical attention for suspected cases
• Educating caregivers and teachers about the risks and symptoms of epiglottitis
• Dispelling myths and misconceptions about throat infections and their potential severity

By improving public understanding of epiglottitis, we can potentially reduce the incidence of severe cases and associated complications.

Epiglottitis in the Context of Global Health

The global landscape of epiglottitis varies significantly across different regions and healthcare systems. How does the incidence and management of epiglottitis differ worldwide?

Developed Countries

In nations with widespread access to Hib vaccination and advanced healthcare systems, epiglottitis has become relatively rare, particularly in children. These countries typically focus on:

• Maintaining high vaccination rates
• Early detection and prompt treatment of cases
• Managing adult cases, which now comprise the majority of incidents
• Researching non-Hib causes of epiglottitis

Developing Countries

In regions with limited access to vaccines and healthcare resources, epiglottitis remains a more significant concern. Challenges in these areas include:

• Implementing and maintaining vaccination programs
• Improving access to diagnostic tools and treatment facilities
• Training healthcare providers in the recognition and management of epiglottitis
• Addressing underlying factors that may increase susceptibility, such as malnutrition and endemic infections

Global health initiatives aimed at expanding vaccination coverage and improving healthcare infrastructure play a crucial role in reducing the worldwide burden of epiglottitis.

The Psychological Impact of Epiglottitis

The experience of epiglottitis can have significant psychological effects on patients and their families. What are some of the emotional and mental health considerations associated with this condition?

• Acute stress and anxiety during the illness, particularly due to difficulty breathing
• Post-traumatic stress symptoms following recovery, especially in cases requiring intensive care
• Fear of recurrence or development of throat-related anxiety
• Psychological impact on parents and family members witnessing a loved one’s distress
• Potential for medical trauma, affecting future healthcare interactions

Addressing these psychological aspects is an important part of comprehensive care for epiglottitis patients. Support services, including counseling and follow-up mental health screenings, may be beneficial for those affected by this intense medical experience.

Technological Advancements in Epiglottitis Care

As medical technology evolves, new tools and techniques are being developed to enhance the diagnosis and treatment of epiglottitis. How is technology shaping the future of epiglottitis care?

• Advanced imaging techniques for more precise diagnosis
• Telemedicine applications for remote assessment and triage of suspected cases
• Development of smart devices for home monitoring of at-risk individuals
• Artificial intelligence algorithms to assist in early detection and risk stratification
• Innovative airway management devices for less invasive intervention

These technological advancements hold the potential to improve outcomes, reduce complications, and enhance the overall management of epiglottitis cases.

Epiglottitis (Epiglottis) Infection or Inflammation

Written by WebMD Editorial Contributors

• What is Epiglottitis?
• Epiglottitis Causes
• Epiglottitis Symptoms
• Epiglottitis Diagnosis
• Epiglottitis Treatment
• Epiglottitis Complications
• Epiglottitis Prevention
• Epiglottitis Outlook
• More

Epiglottitis is a medical emergency. If not treated quickly, it can be fatal.  

The epiglottis is a flap of tissue at the base of the tongue that keeps food from going into the trachea, or windpipe, during swallowing. When it gets infected or inflamed, it can obstruct (block) or close off your windpipe, which makes you unable to breathe.

Respiratory infection, things in the environment, or trauma may cause inflammation and infection of other areas around the throat. The infection and inflammation may spread to the epiglottis and other areas. 

Epiglottitis usually begins as an inflammation and swelling between the base of the tongue and the epiglottis. With continued inflammation and swelling of the epiglottis, complete blockage of the airway may occur, leading to suffocation and death. Even a little narrowing of the windpipe can dramatically increase the resistance of an airway, making breathing much more difficult.

Autopsies of people with epiglottitis have shown distortion of the epiglottis and its associated structures, including the formation of abscesses (pockets of infection). For unknown reasons, adults with epiglottic involvement are more likely than children to develop epiglottic abscesses.

Epiglottitis was first described in the 18th century but was first accurately defined by Andrew Lemierre in 1936. In fact, although George Washington’s death in 1796 was attributed by some to quinsy (today we call it peritonsillar abscess), which is a pocket of pus behind the tonsils, it could have actually been due to epiglottitis.

In the past, epiglottitis was more common in children than in adults. This difference was believed to be because of the smaller diameter of children’s epiglottic opening when compared with those of adults. Epiglottitis in children under the age of 1 year is unusual.

In the past, Haemophilus influenzae type b (or Hib) was the most common organism related to epiglottitis. Since 1985, with the widespread vaccination against Hib, far fewer children have gotten the disease. 

A conservative estimate of the incidence of epiglottitis is 1 case per 100,000 people in the U.S. each year.

Most epiglottitis is caused by bacterial, fungal or viral infection, especially among adults.

• Common infectious causes are Haemophilus influenzae, Streptococcus pneumoniae and other strep species, and respiratory tract viruses. People who have immune system problems are in greater danger of infection.

• Other types of epiglottitis are caused by heat damage. Thermal epiglottitis occurs from drinking hot liquids; eating very hot solid foods; or using illicit drugs (i.e., inhaling the tips of marijuana cigarettes or metal pieces from crack cocaine pipes). In these cases, the epiglottitis from thermal injury is similar to the illness caused by infection.

Unusual causes of epiglottitis include brown recluse spider bites to the ear, which may result in swelling, or eating buffalo fish, which may cause an allergic-like reaction and swelling. Blunt trauma or something blocking the throat may also lead to epiglottitis.

When epiglottitis strikes, it usually occurs quickly, from just a few hours to a few days. The most common symptoms include sore throat, muffling or changes in the voice, difficulty speaking, swallowing or breathing, fever, and fast heart rate.

Symptoms in children often happen within hours. They include:

• Upper respiratory infections 

• Sudden, very sore throat 

• Fever  

• Stridor, a high-pitched whistling sound when your child breathes in

• Muffled voice 

• Drooling

• No coughing

• Anxiety or restlessness  

• Leaning forward while seated

• Keeping their mouth open

• Not being able to talk

• Trouble breathing

• Blue skin, a condition called cyanosis  

Adults and older children often have symptoms that come on over a few days, such as:

• Very sore throat

• Fever 

• Hoarse or muffled voice 

• Stridor 

• Pain or difficulty in swallowing 

• Drooling

• Irritability or restlessness 

When to seek medical care

Call 911 or go to the nearest emergency room if you have a sore throat accompanied by any of the following signs and symptoms:

• Muffled voice

• Swallowing problems

• Difficulty speaking

• Fast heartbeat

• Irritability

• Bluish skin

• Respiratory distress with drooling, shortness of breath, rapid shallow breathing, very ill-looking appearance, sitting upright with a tendency to lean forward, and stridor (high-pitched sound when breathing in)

Epiglottitis is a medical emergency. Anyone who might have epiglottitis should be taken to the hospital immediately. Try to keep the person as calm and comfortable as possible. Make no attempt at home to inspect the throat of a person suspected of having epiglottitis. This can cause the windpipe and surrounding tissues to close and an irregular heart beat, which can lead to respiratory and/or cardiac arrest (stopping of breathing and/or heart) and death.

• The doctor may perform X-rays or simply look at the epiglottis and the windpipe by laryngoscopy.

  • The doctor may find that the pharynx is inflamed with a beefy, cherry-red, stiff and swollen epiglottis.

  • Manipulating the epiglottis may result in sudden fatal airway obstruction, and irregular slow heart rates have occurred with attempts at intubation (putting a tube down the throat and placing the person on a machine that helps with breathing). That’s why the doctor will likely use an operating room or intensive care unit to examine the throat.

• Other laboratory tests may include:

  • Blood tests to look for infection or inflammation

  • Tests to measure oxygen in the blood

  • Blood cultures (blood samples that may grow bacteria), which can indicate the cause of the epiglottitis

  • Other tests to find antibodies to specific bacteria or viruses (immunologic tests)

  • In intubated patients, epiglottal culture

These laboratory tests may not be useful in diagnosing epiglottitis until the person is stable. Also, the anxiety from having blood drawn or cultures taken from the throat may cause the unstable epiglottis to close off, completely blocking the airway and creating an emergency with only a few minutes to correct.

Even with all of our modern technology, epiglottitis is not easy to diagnose. It is often mistaken for strep throat or croup. Epiglottitis differs from croup by its worsening progress, lack of a barking cough, and a cherry-red, swollen epiglottis (unlike a red, unswollen epiglottis in croup). One way doctors can tell epiglottitis from croup is by taking X-rays of the neck, which can show the swollen epiglottis.

Other misdiagnoses of epiglottitis include diphtheria, peritonsillar abscess, and infectious mononucleosis.

Non-infectious causes have been mistaken as angioedema (swelling of the tissues in the airway), laryngeal inflammation or spasm, laryngeal trauma, cancerous growths, allergic reactions, thyroid gland infection, epiglottic hematoma (trapped blood pocket), hemangioma (abnormal collection of blood vessels), or inhalational injury.

Immediate hospitalization is required whenever the diagnosis of epiglottitis is suspected. The person is in danger of sudden and unpredictable closing of the airway. So doctors must establish a secure way for the person to breathe. Antibiotics may be given.

• Treatment of epiglottitis may start with making the person as comfortable as possible. For instance, an ill child may be placed in a dimly lit room with the parent holding the child. Then, the child may get humidified oxygen while being closely watched. If there are no signs of respiratory distress, IV fluids may be helpful. It is important to prevent anxiety, because it may lead to an acute airway obstruction, especially in children.

• People with possible signs of airway obstruction require laryngoscopy in the operating room or intensive care unit with proper staff and airway intervention equipment. In very severe cases, the doctor may need to perform a cricothyrotomy (cutting the neck to insert a breathing tube directly into the windpipe).

• IV antibiotics may effectively control inflammation and get rid of the infection from the body. Antibiotics are usually prescribed to treat the most common types of bacteria. Blood cultures are usually taken to show whether an organism is growing in the blood that could be causing the epiglottitis. In many cases, blood cultures may not show if this is the problem. If a patient is intubated, cultures taken directly from the epiglottis may work better.

Corticosteroids and epinephrine have been used in the past. However, many experts now doubt that these drugs are helpful in most cases of epiglottitis.

Treatment follow-up 

Take all antibiotics until the full course is completed. Keep all follow-up appointments with the doctor — and with the surgeon if a breathing tube had to be placed through the neck. The surgeon will remove the tube and make sure the site is healing well. Most people feel much better before leaving the hospital, so taking the antibiotics and returning to the hospital if there are any problems are the most important parts of follow-up.

Possible complications of epiglottitis include: 

Epiglottitis can often be prevented with proper vaccination against H influenza type b (Hib). Adults usually do not need the vaccine unless they have immune problems like sickle cell anemia, splenectomy (removal of the spleen), cancers, or other diseases affecting the immune system.

If other people live with a Hib-infected person, preventive drugs such as rifampin (Rifadin) should be given to anyone else in the house who is:

• Under the age of 4 and has not received all the Hib vaccinations

• Under 12 months and has not finished the first series of Hib vaccine

• Under age 18 with a weakened immune system

This is done to make sure that both the person with the illness and the rest of the household do not have the bacteria. This prevents a “carrier state” from forming in which a person has the bacteria in the body but is not actively sick. Carriers can still spread the infection to other family members.

A person with epiglottitis can recover very well with a good prognosis if the condition is caught early and treated in time. In fact, a good majority of people with epiglottitis do well and recover without problems. But if the person was not brought to the hospital early and was not appropriately diagnosed and treated, the prognosis may range from long-range illness to death.

• Before 1973, about 32% of adults with epiglottitis died from the disease. With current vaccination programs and earlier recognition and treatment, the death rate from epiglottitis is estimated to be less than 1%. The death rate from epiglottitis in adults is higher than that of children because the condition can be misdiagnosed.

Epiglottitis can also occur with other infections in adults, such as pneumonia. If it is caught early and treated, a person can expect to fully recover. Most of the deaths come from failure to diagnose it quickly and obstruction of the airway. As with any serious infection, bacteria may enter the blood, a condition called bacteremia, which may result in infections in other systems and sepsis (severe infection with shock, often with respiratory failure).

Top Picks

Epiglottitis (Epiglottis) Infection or Inflammation

Written by WebMD Editorial Contributors

• What is Epiglottitis?
• Epiglottitis Causes
• Epiglottitis Symptoms
• Epiglottitis Diagnosis
• Epiglottitis Treatment
• Epiglottitis Complications
• Epiglottitis Prevention
• Epiglottitis Outlook
• More

Epiglottitis is a medical emergency. If not treated quickly, it can be fatal.  

The epiglottis is a flap of tissue at the base of the tongue that keeps food from going into the trachea, or windpipe, during swallowing. When it gets infected or inflamed, it can obstruct (block) or close off your windpipe, which makes you unable to breathe.

Respiratory infection, things in the environment, or trauma may cause inflammation and infection of other areas around the throat. The infection and inflammation may spread to the epiglottis and other areas. 

Epiglottitis usually begins as an inflammation and swelling between the base of the tongue and the epiglottis. With continued inflammation and swelling of the epiglottis, complete blockage of the airway may occur, leading to suffocation and death. Even a little narrowing of the windpipe can dramatically increase the resistance of an airway, making breathing much more difficult.

Autopsies of people with epiglottitis have shown distortion of the epiglottis and its associated structures, including the formation of abscesses (pockets of infection). For unknown reasons, adults with epiglottic involvement are more likely than children to develop epiglottic abscesses.

Epiglottitis was first described in the 18th century but was first accurately defined by Andrew Lemierre in 1936. In fact, although George Washington’s death in 1796 was attributed by some to quinsy (today we call it peritonsillar abscess), which is a pocket of pus behind the tonsils, it could have actually been due to epiglottitis.

In the past, epiglottitis was more common in children than in adults. This difference was believed to be because of the smaller diameter of children’s epiglottic opening when compared with those of adults. Epiglottitis in children under the age of 1 year is unusual.

In the past, Haemophilus influenzae type b (or Hib) was the most common organism related to epiglottitis. Since 1985, with the widespread vaccination against Hib, far fewer children have gotten the disease. 

A conservative estimate of the incidence of epiglottitis is 1 case per 100,000 people in the U. S. each year.

Most epiglottitis is caused by bacterial, fungal or viral infection, especially among adults.

• Common infectious causes are Haemophilus influenzae, Streptococcus pneumoniae and other strep species, and respiratory tract viruses. People who have immune system problems are in greater danger of infection.

• Other types of epiglottitis are caused by heat damage. Thermal epiglottitis occurs from drinking hot liquids; eating very hot solid foods; or using illicit drugs (i.e., inhaling the tips of marijuana cigarettes or metal pieces from crack cocaine pipes). In these cases, the epiglottitis from thermal injury is similar to the illness caused by infection.

Unusual causes of epiglottitis include brown recluse spider bites to the ear, which may result in swelling, or eating buffalo fish, which may cause an allergic-like reaction and swelling. Blunt trauma or something blocking the throat may also lead to epiglottitis.

When epiglottitis strikes, it usually occurs quickly, from just a few hours to a few days. The most common symptoms include sore throat, muffling or changes in the voice, difficulty speaking, swallowing or breathing, fever, and fast heart rate.

Symptoms in children often happen within hours. They include:

• Upper respiratory infections 

• Sudden, very sore throat 

• Fever  

• Stridor, a high-pitched whistling sound when your child breathes in

• Muffled voice 

• Drooling

• No coughing

• Anxiety or restlessness  

• Leaning forward while seated

• Keeping their mouth open

• Not being able to talk

• Trouble breathing

• Blue skin, a condition called cyanosis  

Adults and older children often have symptoms that come on over a few days, such as:

• Very sore throat

• Fever 

• Hoarse or muffled voice 

• Stridor 

• Pain or difficulty in swallowing 

• Drooling

• Irritability or restlessness 

When to seek medical care

Call 911 or go to the nearest emergency room if you have a sore throat accompanied by any of the following signs and symptoms:

• Muffled voice

• Swallowing problems

• Difficulty speaking

• Fast heartbeat

• Irritability

• Bluish skin

• Respiratory distress with drooling, shortness of breath, rapid shallow breathing, very ill-looking appearance, sitting upright with a tendency to lean forward, and stridor (high-pitched sound when breathing in)

Epiglottitis is a medical emergency. Anyone who might have epiglottitis should be taken to the hospital immediately. Try to keep the person as calm and comfortable as possible. Make no attempt at home to inspect the throat of a person suspected of having epiglottitis. This can cause the windpipe and surrounding tissues to close and an irregular heart beat, which can lead to respiratory and/or cardiac arrest (stopping of breathing and/or heart) and death.

• The doctor may perform X-rays or simply look at the epiglottis and the windpipe by laryngoscopy.

  • The doctor may find that the pharynx is inflamed with a beefy, cherry-red, stiff and swollen epiglottis.

  • Manipulating the epiglottis may result in sudden fatal airway obstruction, and irregular slow heart rates have occurred with attempts at intubation (putting a tube down the throat and placing the person on a machine that helps with breathing). That’s why the doctor will likely use an operating room or intensive care unit to examine the throat.

• Other laboratory tests may include:

  • Blood tests to look for infection or inflammation

  • Tests to measure oxygen in the blood

  • Blood cultures (blood samples that may grow bacteria), which can indicate the cause of the epiglottitis

  • Other tests to find antibodies to specific bacteria or viruses (immunologic tests)

  • In intubated patients, epiglottal culture

These laboratory tests may not be useful in diagnosing epiglottitis until the person is stable. Also, the anxiety from having blood drawn or cultures taken from the throat may cause the unstable epiglottis to close off, completely blocking the airway and creating an emergency with only a few minutes to correct.

Even with all of our modern technology, epiglottitis is not easy to diagnose. It is often mistaken for strep throat or croup. Epiglottitis differs from croup by its worsening progress, lack of a barking cough, and a cherry-red, swollen epiglottis (unlike a red, unswollen epiglottis in croup). One way doctors can tell epiglottitis from croup is by taking X-rays of the neck, which can show the swollen epiglottis.

Other misdiagnoses of epiglottitis include diphtheria, peritonsillar abscess, and infectious mononucleosis.

Non-infectious causes have been mistaken as angioedema (swelling of the tissues in the airway), laryngeal inflammation or spasm, laryngeal trauma, cancerous growths, allergic reactions, thyroid gland infection, epiglottic hematoma (trapped blood pocket), hemangioma (abnormal collection of blood vessels), or inhalational injury.

Immediate hospitalization is required whenever the diagnosis of epiglottitis is suspected. The person is in danger of sudden and unpredictable closing of the airway. So doctors must establish a secure way for the person to breathe. Antibiotics may be given.

• Treatment of epiglottitis may start with making the person as comfortable as possible. For instance, an ill child may be placed in a dimly lit room with the parent holding the child. Then, the child may get humidified oxygen while being closely watched. If there are no signs of respiratory distress, IV fluids may be helpful. It is important to prevent anxiety, because it may lead to an acute airway obstruction, especially in children.

• People with possible signs of airway obstruction require laryngoscopy in the operating room or intensive care unit with proper staff and airway intervention equipment. In very severe cases, the doctor may need to perform a cricothyrotomy (cutting the neck to insert a breathing tube directly into the windpipe).

• IV antibiotics may effectively control inflammation and get rid of the infection from the body. Antibiotics are usually prescribed to treat the most common types of bacteria. Blood cultures are usually taken to show whether an organism is growing in the blood that could be causing the epiglottitis. In many cases, blood cultures may not show if this is the problem. If a patient is intubated, cultures taken directly from the epiglottis may work better.

Corticosteroids and epinephrine have been used in the past. However, many experts now doubt that these drugs are helpful in most cases of epiglottitis.

Treatment follow-up 

Take all antibiotics until the full course is completed. Keep all follow-up appointments with the doctor — and with the surgeon if a breathing tube had to be placed through the neck. The surgeon will remove the tube and make sure the site is healing well. Most people feel much better before leaving the hospital, so taking the antibiotics and returning to the hospital if there are any problems are the most important parts of follow-up.

Possible complications of epiglottitis include: 

Epiglottitis can often be prevented with proper vaccination against H influenza type b (Hib). Adults usually do not need the vaccine unless they have immune problems like sickle cell anemia, splenectomy (removal of the spleen), cancers, or other diseases affecting the immune system.

If other people live with a Hib-infected person, preventive drugs such as rifampin (Rifadin) should be given to anyone else in the house who is:

• Under the age of 4 and has not received all the Hib vaccinations

• Under 12 months and has not finished the first series of Hib vaccine

• Under age 18 with a weakened immune system

This is done to make sure that both the person with the illness and the rest of the household do not have the bacteria. This prevents a “carrier state” from forming in which a person has the bacteria in the body but is not actively sick. Carriers can still spread the infection to other family members.

A person with epiglottitis can recover very well with a good prognosis if the condition is caught early and treated in time. In fact, a good majority of people with epiglottitis do well and recover without problems. But if the person was not brought to the hospital early and was not appropriately diagnosed and treated, the prognosis may range from long-range illness to death.

• Before 1973, about 32% of adults with epiglottitis died from the disease. With current vaccination programs and earlier recognition and treatment, the death rate from epiglottitis is estimated to be less than 1%. The death rate from epiglottitis in adults is higher than that of children because the condition can be misdiagnosed.

Epiglottitis can also occur with other infections in adults, such as pneumonia. If it is caught early and treated, a person can expect to fully recover. Most of the deaths come from failure to diagnose it quickly and obstruction of the airway. As with any serious infection, bacteria may enter the blood, a condition called bacteremia, which may result in infections in other systems and sepsis (severe infection with shock, often with respiratory failure).

Top Picks

Epiglottitis: Causes of epiglottitis, Prevalence of the disease, Diagnosis and treatment of epiglottitis

Epiglottitis is commonly referred to as inflammation of the epiglottis and surrounding tissues. It can lead to severe airway obstruction. Acute epiglottitis occurs in children aged 2-4 years. However, older children and adults can also get sick.

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Here you can choose a doctor who specializes in the treatment of Epiglottitis If you are not sure about the diagnosis, make an appointment with a general practitioner or general practitioner to clarify the diagnosis.

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Which doctor treats Epiglottitis

5

Pediatric otolaryngologist (ENT ) of the highest category, candidate of medical sciences, has been treating diseases in children related to the ears, throat and nose for 28 years. Specializes in otolaryngology, phoniatrics, otosurgery, plastic and reconstructive surgery

PRO HEALTH clinic