What is epiglottitis. How does it affect breathing. What are the common causes of epiglottitis. What are the symptoms of epiglottitis in children and adults. How is epiglottitis diagnosed and treated. Can epiglottitis be prevented. What is the outlook for people with epiglottitis.

Understanding Epiglottitis: A Potentially Life-Threatening 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 flap plays a crucial role in preventing food and liquids from entering the trachea (windpipe) during swallowing. When the epiglottis becomes infected or inflamed, it can obstruct the airway, making breathing difficult or even impossible.

Is epiglottitis a medical emergency? Yes, epiglottitis is considered a medical emergency that requires immediate attention. If left untreated, it can rapidly progress and become fatal due to complete airway obstruction.

The Etiology of Epiglottitis: Exploring Common Causes

Epiglottitis can be caused by various factors, with bacterial infections being the most common culprit. Historically, Haemophilus influenzae type b (Hib) was the primary cause of epiglottitis, especially in children. However, the widespread use of Hib vaccines has significantly reduced its incidence.

What are the current leading causes of epiglottitis?

• Bacterial infections (e.g., Streptococcus pneumoniae, other strep species)
• Viral infections affecting the respiratory tract
• Fungal infections (particularly in immunocompromised individuals)
• Thermal injury from hot liquids or foods
• Inhalation of irritants (e.g., illicit drugs)
• Trauma to the throat area
• Allergic reactions (rare cases)

Are certain individuals more susceptible to epiglottitis? People with weakened immune systems are at a higher risk of developing epiglottitis. Additionally, adults are now more commonly affected than children due to widespread vaccination against Hib.

Recognizing the Signs and Symptoms of Epiglottitis

The onset of epiglottitis can be rapid, with symptoms developing within hours or over a few days. The presentation may differ slightly between children and adults, but both require immediate medical attention.

Epiglottitis Symptoms in Children

How quickly do symptoms appear in children? In children, epiglottitis symptoms often develop rapidly, sometimes within hours. These may include:

• Sudden, severe sore throat
• High fever
• Stridor (high-pitched whistling sound when breathing)
• Muffled or changed voice
• Difficulty speaking
• Drooling
• Anxiety or restlessness
• Sitting in a “tripod” position (leaning forward with mouth open)
• Bluish skin color (cyanosis) in severe cases

Epiglottitis Symptoms in Adults

Do adults experience different symptoms compared to children? While there is some overlap, adults may experience a more gradual onset of symptoms over several days:

• Severe sore throat
• Fever
• Hoarse or muffled voice
• Difficulty swallowing
• Painful swallowing
• Drooling
• Stridor
• Shortness of breath

Diagnosing Epiglottitis: A Delicate Process

Diagnosing epiglottitis requires a careful approach due to the risk of further airway obstruction. Medical professionals must balance the need for a definitive diagnosis with the urgency of treatment.

How is epiglottitis diagnosed? The diagnosis typically involves:

1. Clinical evaluation: Assessing symptoms and examining the patient’s posture and breathing
2. Lateral neck X-ray: To visualize the “thumb sign” indicative of a swollen epiglottis
3. Laryngoscopy: A cautious examination of the throat using a flexible scope
4. Blood tests: To check for signs of infection and inflammation
5. Throat cultures: To identify the specific pathogen causing the infection

Why is caution necessary during diagnosis? Manipulating the airway or causing distress to the patient can potentially trigger complete airway obstruction, making it crucial to perform diagnostic procedures in a controlled setting with emergency equipment readily available.

Treatment Approaches for Epiglottitis

The primary goals of epiglottitis treatment are to secure the airway and address the underlying cause of inflammation. Treatment often requires a multidisciplinary approach involving emergency medicine, otolaryngology, and critical care specialists.

What are the key components of epiglottitis treatment?

• Airway management: This may include intubation or, in severe cases, tracheostomy
• Antibiotics: Intravenous antibiotics are administered to combat bacterial infections
• Corticosteroids: To reduce inflammation and swelling of the epiglottis
• Supportive care: Including intravenous fluids, pain management, and close monitoring
• Oxygen therapy: To ensure adequate oxygenation during recovery

How long does treatment typically last? The duration of treatment can vary depending on the severity of the condition and the patient’s response. Most patients require hospitalization for several days to a week, with continued antibiotic therapy and monitoring.

Preventing Epiglottitis: Vaccination and Awareness

While not all cases of epiglottitis can be prevented, certain measures can significantly reduce the risk of developing this condition.

What are effective strategies for preventing epiglottitis?

• Vaccination: Ensuring up-to-date Hib vaccinations, especially for children
• Proper hygiene: Practicing good hand hygiene to reduce the spread of infectious agents
• Avoiding triggers: Being cautious with very hot foods and liquids
• Prompt treatment of infections: Addressing upper respiratory infections quickly
• Avoiding substance abuse: Refraining from inhaling illicit drugs that can cause thermal injury

Is the Hib vaccine effective in preventing epiglottitis? Yes, the widespread use of the Hib vaccine has dramatically reduced the incidence of epiglottitis, especially in children. However, it’s important to note that other pathogens can still cause the condition.

Complications and Long-Term Outlook for Epiglottitis Patients

While epiglottitis can be life-threatening if not treated promptly, most patients who receive timely and appropriate care recover fully. However, some complications may occur.

What potential complications can arise from epiglottitis?

• Airway obstruction: The most immediate and severe complication
• Epiglottic abscess: More common in adults than children
• Pneumonia: As a secondary infection
• Sepsis: In cases of severe bacterial infection
• Pulmonary edema: Due to negative pressure from breathing against an obstructed airway

What is the long-term prognosis for epiglottitis survivors? With proper treatment, most patients recover completely within a week to ten days. Long-term complications are rare, but some patients may experience persistent throat discomfort or voice changes for a short period after recovery.

Epiglottitis in Special Populations: Considerations and Challenges

While epiglottitis can affect anyone, certain populations may face unique challenges or require special considerations in diagnosis and treatment.

Epiglottitis in Immunocompromised Patients

How does immunosuppression affect epiglottitis? Immunocompromised individuals are at higher risk of developing epiglottitis and may experience more severe symptoms or atypical presentations. They may also be more susceptible to fungal causes of epiglottitis, which are rare in the general population.

Epiglottitis in the Elderly

Do older adults face different risks with epiglottitis? Elderly patients may have a more subtle presentation of symptoms, making early diagnosis challenging. They are also more likely to have comorbidities that can complicate treatment and recovery.

Epiglottitis in Pregnancy

What special considerations are necessary for pregnant women with epiglottitis? Pregnant women require careful management to ensure both maternal and fetal well-being. Treatment decisions, particularly regarding medication choices and airway management, must consider potential impacts on the developing fetus.

By understanding these population-specific considerations, healthcare providers can better tailor their approach to diagnosis and treatment, ensuring the best possible outcomes for all patients with epiglottitis.

Advances in Epiglottitis Research and Future Directions

As medical science progresses, our understanding of epiglottitis continues to evolve, leading to improved diagnostic techniques and treatment strategies.

What recent advancements have been made in epiglottitis research?

• Improved imaging techniques: Enhanced CT and MRI protocols for more accurate diagnosis
• Molecular diagnostics: Rapid identification of causative pathogens
• Novel antibiotic therapies: Development of new antimicrobial agents for resistant strains
• Airway management innovations: Less invasive techniques for securing the airway

What are the future directions for epiglottitis research and treatment? Researchers are focusing on several areas to improve epiglottitis management:

1. Developing more targeted therapies to reduce inflammation quickly
2. Investigating the role of the microbiome in epiglottitis susceptibility and recovery
3. Exploring non-invasive monitoring techniques to assess airway status
4. Studying long-term outcomes to better understand and prevent potential complications
5. Improving vaccination strategies to protect against emerging pathogens

These ongoing research efforts hold promise for further reducing the incidence of epiglottitis and improving outcomes for those affected by this serious condition.

Global Perspectives on Epiglottitis: Incidence and Management Variations

The incidence and management of epiglottitis vary across different regions of the world, influenced by factors such as vaccination rates, healthcare access, and local pathogens.

How does the incidence of epiglottitis differ globally? In countries with widespread Hib vaccination programs, the incidence of epiglottitis has decreased significantly. However, in regions with limited vaccine coverage, Hib-related epiglottitis remains a concern, particularly in pediatric populations.

Are there regional variations in epiglottitis management? While the core principles of epiglottitis management remain consistent globally, there are some regional differences:

• Resource availability: High-income countries may have more advanced airway management tools and intensive care facilities
• Antibiotic preferences: Choice of antibiotics may vary based on local resistance patterns
• Cultural factors: Some regions may face challenges in implementing preventive measures due to cultural beliefs or practices
• Healthcare systems: Differences in healthcare delivery models can impact the speed and accessibility of treatment

What global initiatives are addressing epiglottitis? International health organizations are working to:

1. Expand vaccination programs in low- and middle-income countries
2. Improve global surveillance of epiglottitis and related conditions
3. Develop standardized treatment protocols adaptable to various resource settings
4. Enhance education and awareness among healthcare providers worldwide

These global efforts aim to reduce disparities in epiglottitis prevention and treatment, ultimately improving outcomes for patients across all regions.

The Role of Public Education in Epiglottitis Prevention and Early Detection

Public awareness plays a crucial role in the prevention of epiglottitis and in ensuring prompt medical attention when symptoms arise. Education initiatives can significantly impact the overall incidence and outcomes of this condition.

Why is public education important in combating epiglottitis? Informed individuals are more likely to:

• Recognize the signs and symptoms of epiglottitis
• Seek immediate medical attention when necessary
• Understand the importance of vaccination
• Practice preventive measures in their daily lives

What key messages should be included in public education campaigns about epiglottitis?

1. The importance of vaccination, particularly the Hib vaccine for children
2. Recognition of early warning signs and symptoms
3. The urgency of seeking medical care for suspected epiglottitis
4. Basic preventive measures, such as good hygiene practices
5. Awareness of risk factors and potential complications

How can healthcare providers contribute to public education on epiglottitis? Healthcare professionals can play a vital role by:

• Discussing epiglottitis prevention during routine check-ups
• Providing informational materials in waiting rooms and clinics
• Participating in community health events to raise awareness
• Utilizing social media and other digital platforms to share accurate information

By focusing on public education, communities can work together to reduce the incidence of epiglottitis and ensure that those affected receive timely and appropriate care.

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.

Articles on the topic Epiglottitis:

Causes of epiglottitis

Prevalence of the disease

Symptoms of epiglottitis

900 13 Diagnosis and treatment of epiglottitis

Which doctor treats Epiglottitis

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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