What is Epiglottitis?

Epiglottitis can be a life-threatening condition that happens when the epiglottis — which is a small cartilage “lid” that covers your windpipe — swells or forms inflammation, blocking the flow of air into your lungs.

Some elements that can trigger the epiglottis to swell — burns from hot liquids, immediate injury to your throat and numerous infections. The most prevalent cause of epiglottitis in children in the past was infection with Haemophilus influenza type b (Hib). Similarly, it is the bacterium that produces meningitis, pneumonia, and viri or bacteria within the bloodstream. Epiglottitis can transpire at any age.

Routine Hib vaccination for newborns has made epiglottitis a rare occurrence. However, epiglottitis remains a challenge. If you speculate that you or someone in your family has epiglottitis, find emergency help as soon you as you can. Quick treatment can prevent life-threatening complications.

Symptoms
Symptoms in children
In children, signs and symptoms of epiglottitis may develop within a matter of hours, including:

  • Fever
  • Abnormal, high-pitched sound when breathing in (stridor)
  • A severe sore throat
  • Abnormal, high-pitched sound when breathing in (stridor)
  • Drooling
  • Difficult and painful swallowing
  • Improved comfort when sitting up or leaning forward
  • Anxious, restless behavior

Indications of Epiglottitis in adults
For adults, signs and symptoms may emerge more slowly, over days rather than hours. Signs and symptoms may include:

  • A severe sore throat
  • Fever
  • Difficulty breathing
  • A muffled or hoarse voice
  • Abnormal, high-pitched sound when breathing in (stridor)
  • Difficulty swallowing
  • Drooling

When should I See a physician
Epiglottitis is a health emergency. If you or someone you know abruptly has trouble swallowing and breathing, use your local emergency number and go to the nearest hospital emergency department. Do your best to keep calm and keep the person who is suffering quiet and upright, because this position will enable easier breathing. Don’t try to examine the person’s throat yourself. This can make the situation worse.

Causes
Epiglottitis is triggered by contamination or an injury.

Infection
In the past, a frequent cause of swelling and inflammation of the epiglottis and surrounding tissues was infection with Haemophilus influenza type b (Hib) bacteria. Hib is responsible for some severe conditions, the most prevalent of which is meningitis. This is now much less common in advanced/developed countries primarily due to Hib immunization in children.

Hib is passed through infected droplets sneezed or coughed into the air. It’s plausible to harbor Hib in your nose and throat without growing ill — though you still have the opportunity to disperse the bacteria to others.

In adults, other viruses and bacteria also can cause swelling of the epiglottis, including:

Streptococcus pneumoniae (pneumococcus), another bacterium that can produce pneumonia, meningitis, blood infection (septicemia) and ear infections
Streptococcus A, B, and C, a group of bacteria that also can cause diseases ranging from strep throat to blood infections
Injury
Physical injury, such as an immediate stroke to the throat, can develop epiglottitis. So can blisters from drinking caustic liquids or extremely hot drinks.

You also may generate signs and symptoms comparable to those of epiglottitis if you:

  • Swallow a chemical that burns your throat
  • Swallow a foreign object
  • Smoke drugs, such as heroine pipes or crack cocaine

Risk factors
Certain factors increase the risk of developing epiglottitis, including:

Being male. Epiglottitis impacts more males than females.
Having a compromised immune system. If your immune system has been impaired by illness or medication, you’re more susceptible to the bacterial infections that may produce epiglottitis.
Lacking adequate vaccination. Delayed or skipped immunizations can leave a child vulnerable to Hib and increases the risk of epiglottitis.
Complications
Epiglottitis can cause some complications, including:

Respiratory failure. The epiglottis is a small, movable “lid” just above the larynx that prevents food and drinks from entering your windpipe. But if the epiglottis becomes swollen — either from infection or injury — the airway narrows and may become completely blocked. This can deteriorate into respiratory failure — a life-threatening ailment in which the level of oxygen in the blood drops dangerously low, or the level of carbon dioxide becomes excessively high.
Spreading infection. Sometimes the bacteria that cause epiglottitis cause infections elsewhere in the body, such as pneumonia, meningitis or a blood infection (sepsis).

Prevention

Hib vaccine
Immunization with the Hib vaccine is an effective way to prevent epiglottitis caused by Hib. In the United States, children usually receive the vaccine in three or four doses:

  • At two months
  • At four months
  • At six months if your child is given a four-dose vaccine
  • At 12 to 15 months
  • The Hib vaccine is not given to children older than age 5 or adults because they’re less inclined to develop Hib infection. But the Centers for Disease Control and Prevention suggests the vaccine for older children and adults whose immune systems have been weakened by:
  • Sickle cell disease
  • HIV/AIDS
  • Chemotherapy
  • Spleen removal

Medications to limit rejection of organ or bone marrow transplants

Vaccine side effects
Allergic reaction. Seek prompt medical assistance if you have an allergic reaction. Though rare, an allergic response may cause difficulty breathing, hives, wheezing, weakness, accelerated dizziness or heartbeat within minutes or a few hours after the shot.
Possible mild side effects or consequences. These include warmth, redness, swelling or pain at the injection site and fever.
Commonsense precautions
Of course, the Hib vaccine can not offer guarantees. Immunized children have been identified to develop epiglottitis — and other germs can cause epiglottitis, too. That’s where good sense precautions come in:

Do not share or exchange your items.
Wash your hands consistently and often.
Use an alcohol-based hand sanitizer if soap and water aren’t available.

Diagnosis
If the medical team speculates epiglottitis, the priority is to guarantee that your or your child’s airway is open and that adequate oxygen is getting through.

Initial test
A pulse oximeter is a medical device that estimates blood oxygen levels. This device:

Clips onto a finger
Measures a calculation of the saturation of oxygen in your blood
If oxygen saturation levels drop too low, you or your child may need help breathing.

Tests after stabilizing breathing
Throat examination. Utilizing a flexible fiber-optic-lighted tube, the physician may observe deeper into your child’s throat to see what’s causing the symptoms. A local anesthetic can assist in relieving any discomfort.
Chest or neck X-ray. Due to the danger of sudden breathing difficulties, children may have X-rays completed at their bedside rather than in the radiology department — but only following securing the airway for protection. With epiglottitis, the X-ray may reveal what looks like a thumbprint in the neck, an indication of an enlarged epiglottis.
A throat culture and blood tests. For the culture, the epiglottis is wiped with a cotton swab, and the tissue sample is checked for Hib. Blood cultures are usually taken because bacteremia — a severe bloodstream infection — may accompany epiglottitis.

Treatment
Treatment of epiglottitis involves first making sure you or your child can breathe, and then treating any identified infection.

Helping you breathe
The priority in treating epiglottitis is ensuring that you or your child is receiving enough air. This may mean:

Wearing a mask – This mask provides oxygen to the lungs.
Having a breathing tube positioned into the windpipe via the nose or mouth (intubation). The tube must stay in place until the inflammation in your or your child’s throat has reduced — sometimes for several days.
Injecting a needle into the trachea (needle tracheostomy). In extreme cases or if more conventional measures fail, the physician may need to form an emergency airway by entering a needle directly into a region of cartilage in your or your child’s trachea. This method allows air into your lungs while bypassing the larynx.
Treating infection
If your epiglottitis is associated with infection, intravenous antibiotics will be given once you or your child is getting enough air.

Broad-spectrum antibiotic. Because of the requirement for quick treatment, rather than delay and wait for the results of the blood and tissue cultures, you or your child is expected to be treated with a broad-spectrum drug.
More-targeted antibiotic. The drug may be adjusted later, depending on what’s causing the epiglottitis.