Epiglottitis: Symptoms, Causes, and Treatment

The epiglottis, a little cartilage “lid” that covers the windpipe, swells and causes epiglottitis. The edema prevents air from entering the lungs. Epiglottitis can occur at any age. Haemophilus influenza type b (Hib) bacterial infection is the most frequent cause of epiglottitis in most youngsters. The bacteria also bring on infections with blood, meningitis, and pneumonia.

In children, epiglottitis is infrequent due to routine Hib immunization. It now affects adults more frequently. In order to avoid fatal consequences, the condition requires immediate attention.

What is Epiglottitis?

Acute, sometimes fatal bacterial or viral infections that cause swelling and inflammation of the epiglottis are known as epiglottitis. When swallowing, food cannot pass through the epiglottis, an elastic cartilage structure at the base of the tongue, and into the trachea. This results in respiratory issues, such as stridor, which may worsen with time and eventually clog airways. A medical emergency arises when the edema is enlarged, so that air cannot enter or exit the lungs.

Symptoms

Regardless of the microorganism causing the inflammation, epiglottitis presents with comparable symptoms. The most typical signs and symptoms of epiglottitis are listed below. However, each child may have a unique set of symptoms.

The following symptoms are:

• Viruses of the upper respiratory tract. In certain children, upper respiratory infection symptoms initially manifest as epiglottitis symptoms.
• A sudden, excruciating sore throat and cough
• Fever
• Hoarse voice
• Cyanosis: Bluish skin tone
• Stridor is a loud, high-pitched sound that is typically heard as a child breathes in (expiration), but it can also be heard when they breathe out

Symptoms such as the following might manifest as the illness gets worse:

• Drooling
• Difficulty breathing
• Throat irritation
• Inability to speak
• Leaning forward when sitting
• An individual keeps his/her mouth open

Causes

An upper respiratory tract-transmitted bacterial infection is the primary cause of epiglottitis. Hib bacterium is the cause of most instances.

Epiglottitis is not caused by viruses. However, bacterial infections may become more common as a result of viral illnesses. Children’s injuries from the following may also result in epiglottitis:

• Breathing in fire smoke
• Taking in a strong chemical that causes throat-burning
• Consuming something (a foreign body) that isn’t food
• Rarely, a blow to the neck directly may also result in this illness
• A weak immune system due to certain medicines or diseases also makes you more likely to get this condition
• Airway infection

Diagnosis

Epiglottitis is a life-threatening emergency, so healthcare providers prioritize stabilizing breathing before diagnosing the condition. Once you are stable and it is safe to proceed, they may conduct the following tests:

• Culture tests: A throat swab is sent to a lab to check for bacterial or viral infections.
• Blood tests: These help measure white blood cell levels and detect any bacteria or viruses in your bloodstream.
• Laryngoscopy: A small camera attached to a flexible tube is used to examine your throat.
• Imaging tests: An X-ray might be conducted to evaluate the extent of swelling. In some cases, the inflamed epiglottis may appear like an adult thumb, known as the “thumbprint sign.”

Treatment

Epiglottitis is a medical emergency that requires immediate hospital care to prevent airway obstruction. The treatment focuses on restoring proper breathing, managing the infection, and reducing throat swelling.

1. Airway Management

The primary step is to ensure that the patient’s airway remains open. Depending on the severity, healthcare providers may use:

• Oxygen Therapy: A mask is placed over the nose and mouth to deliver oxygen to the lungs.
• Intubation: In cases of severe airway blockage, a breathing tube is inserted through the mouth or nose into the windpipe.
• Tracheostomy (in severe cases): In severe cases, a small neck incision is made to insert a breathing tube directly into the windpipe. This bypasses the swollen epiglottis, allowing the person to breathe.

2. Medication and Fluids

Once the airway is secured, treatment focuses on combating the infection and reducing inflammation:

• Antibiotics: For bacterial infections, broad-spectrum antibiotics are administered through an intravenous (IV) drip. The medication may be adjusted based on lab results identifying the specific bacteria.
• Anti-inflammatory Medication: Corticosteroids are used to decrease throat swelling and ease breathing.
• Intravenous Fluids: Since swallowing is difficult, fluids are given through an IV to prevent dehydration and provide nutrition until the patient can eat and drink normally.

3. Monitoring and Recovery

Patients with epiglottitis are typically monitored in the intensive care unit (ICU). Oxygen levels are continuously checked, and supportive care is provided until the airway is stable. With prompt medical intervention, most people recover fully and are discharged from the hospital within a week.

Prevention

A vaccination can stop the Hib-causing bacteria from causing epiglottitis. The risk of contracting the illness will decrease after receiving the vaccination.

It is currently not possible to avoid epiglottitis brought on by other bacteria. However, these are far fewer in number. However, here are a few listed preventive measures for epiglottitis:

• Individuals should avoid those who are sick to prevent the spread of airborne diseases or infection.
• When coughing or sneezing, one should cover their mouth with a tissue or the inside of their elbow.
• Hands should be washed with soap and fresh running water.
• Avoiding injuries to the throat
• Experts recommend that babies receive the Hib vaccination three to four times. Depending on the brand of the vaccine used by the doctor, the primary doses are given at 2, 4, and 6 months of age. A booster dose is administered when the child is 12 to 15 months old.

Conclusion

Breathing and swallowing difficulties might be among the many severe symptoms of epiglottitis, or inflammation of the epiglottis. If someone is exhibiting signs of epiglottitis, get help right away by going to the closest emergency facility. When treated promptly and appropriately, epiglottitis typically resolves. Most patients make a full recovery and are discharged from the hospital in less than a week.

When to See the Doctor?

Epiglottitis is a medical emergency requiring immediate care. Seek help if you or someone else has:

• Difficulties in breathing or swallowing
• Drooling or muffled speech

Immediate medical care is essential to avoid a potentially fatal airway obstruction.

Frequently Asked Questions