Epiglottitis

(Supraglottitis)

As a rapidly progressive bacterial infection of the epiglottis (epiglottis) and surrounding tissue may cause a epiglottitis a sudden airway obstruction and death. Symptoms strong sore throat, difficulty swallowing (dysphagia), high fever, salivation and inspiratory stridor occur. To make the diagnosis, the supraglottic structures must be inspected. This should be done very carefully and in some cases threatening clinically only provided a breathing readiness. In addition to protecting the respiratory tract, the treatment consists of antibiotic therapy.

Earlier, the epiglottitis was primarily for children (usually by infection with Haemophilus influenzae type B). But since then the infection could be almost eradicated by widespread Hib vaccination of children today appear more cases in adults. In children and adults are now mainly the timer: Streptococcus pneumoniae, Staphylococcus aureus, non-typable H. influenzae, species, Haemophilus influenzae para, ?-hemolytic streptococci, Branhamella catarrhalis, and Klebsiella pneumoniae. H. influenzae type B continues to be a trigger in adults and unvaccinated children.

As a rapidly progressive bacterial infection of the epiglottis (epiglottis) and surrounding tissue may cause a epiglottitis a sudden airway obstruction and death. Symptoms strong sore throat, difficulty swallowing (dysphagia), high fever, salivation and inspiratory stridor occur. To make the diagnosis, the supraglottic structures must be inspected. This should be done very carefully and in some cases threatening clinically only provided a breathing readiness. In addition to protecting the respiratory tract, the treatment consists of antibiotic therapy. Earlier, the epiglottitis was primarily for children (usually by infection with Haemophilus influenzae type B). But since then the infection could be almost eradicated by widespread Hib vaccination of children today appear more cases in adults. In children and adults are now mainly the timer: Streptococcus pneumoniae, Staphylococcus aureus, non-typable H. influenzae, species, Haemophilus influenzae para, ?-hemolytic streptococci, Branhamella catarrhalis, and Klebsiella pneumoniae. H. influenzae type B continues to be a trigger in adults and unvaccinated children. After bacterial colonization of the nose and throat and local spread of the bacteria there is a supraglottic tissue infection with particularly pronounced inflammation of the epiglottis, the Vallecula epiglottica, the aryepiglottic folds, arytenoid and Larynxventrikel. H. influenzae type B hematogenous seeding is possible. Since the flammable swollen supraglottic structures to narrow the airway, the work of breathing increases, which ultimately leads to respiratory failure. The Clearancefunktion is affected by inflammatory secretions. Symptoms and ailments in children develop abruptly symptoms such as sore throat, dysphagia and pain on swallowing. Within hours, a fatal asphyxia can occur. Very often there is a strong flow of saliva. The feverish child seems frightened and may be additionally detect signs of toxicity (low / missing eye contact, non-recognition of the parents, cyanosis, irritability, inconsolable and not be distracted). Often, dyspnea, tachypnea and inspiratory stridor force the child to sit up, to leaning forward intently with hyperextended neck, vorgeschobenem jaw and mouth open to gasp for air. Are there any efforts this posture (Dreifußzeichen) take on, which may herald respiratory insufficiency. During inhalation are suprasternal, supraclavicular, and subcostal retractions often recognizable. Like symptoms (sore throat, fever, dysphagia and drooling) as for the children also occur in adults, but usually only after> 24 h fully developed. Because their airways have larger diameter, it is less common for obstruction or a fulminant course in adults. Often is not even an oropharyngeal inflammation visible. Nevertheless, strong neck pain should raise the suspicion of a epiglottitis in apparently normal aussehendem pharynx. A delay in diagnosis and treatment increases the risk of airway obstruction and death. Diagnostic Direct inspection (usually in the operating room) radiographs in mild cases with low suspicion Strong sore throat without pharyngitis or strep throat with inspiratory stridor is suggestive of epiglottitis. A inspiratory stridor can also Krupp (viral Laryngotracheobronchitis, see table in children: be caused differential diagnosis epiglottitis or croup, bacterial tracheitis or by foreign bodies in the airways The Dreifußzeichen-sitting posture is taken sometimes in a Peritonsillar- or retropharyngeal On suspicion.. on epiglottitis patients must be instructed to hospital, the diagnosis can be put only after direct inspection, usually with a flexible laryngoscopy (Cave:.. the direct examination of the pharynx and larynx can result in children to complete airway obstruction and should therefore only be careful or only if the conditions for mechanical ventilation are given.) Although radiographs may be helpful to have a child can not be transported only in an X-ray department in stridor. diagnosis, it is leading the way when the epiglottis in the direct laryngoscopy blood red, stiff and edematous represents. For the cultivation of the organism supraglottic tissue and blood cultures are created. Epiglottitis figure provided by Clarence T. Sasaki, M.D. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/epiglottitis_pe_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/epiglottitis_pe_high_de.jpg?la = en & thn = 0 ‘, title:’ epiglottitis ‘description:’ u003Ca id = “v37893988 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eEpiglottitis in an intubated patient. The epiglottis is blood red

Health Life Media Team

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