If left untreated, epiglottitis symptoms can worsen quickly and the patient can die within a matter of hours.
What are the signs and symptoms of epiglottitis ?A symptom is something the patient reports and feels, while a sign is something other people, including a doctor may detect. For example, a headache may be a symptom, while a rash may be a sign.
An affected patient, often a child in some developing nations that don't have widespread Hib vaccinations, may experience :
- Swallowing difficulties, often painful
- A hoarse or muffled voice
- Stridor - a high pitched sound that accompanies respiration, especially when breathing in
- Severe sore throat
- Cyanosis - skin may take on a blue tinge if the patient is not getting enough oxygen
What causes epiglottitis ?
- Hib bacteria (Haemophilus influenzae type b) - infection can cause epiglottitis as well as meningitis and pneumonia. Since widespread vaccinations, incidence of epiglottitis has dropped dramatically.
- Other bacteria - such as the one that commonly causes pneumonia - streptococcus pneumoniae.
- Fungi - especially individuals whose immune systems are weak.
- An injury - if you swallow a very hot drink too quickly there is a risk that the epiglottis will swell. Other injuries, caused by a blow to the neck may also cause epiglottitis.
How is epiglottitis diagnosed ?The medical team will focus on making sure the patient has an adequate supply of oxygen if epiglottitis is suspected, before any diagnostic tests are considered.
- Age :
- Children, aged 3-7, living in countries that do not offer vaccines
- Infants too young to receive vaccination (younger than two months)
- Adults in their 40s (very rare)
- Sex : Males are more prone than females
- Living in close quarters
- Attending day care, being in school, or working in an office
- Weather : more common in winter
- Race : more common among African Americans and Hispanics
- Endotracheal intubation—A breathing tube is inserted through the nose or mouth and fed into the airway. This can only be done if the airway is not swollen shut and should be done by an experienced physician.
- Tracheotomy —A breathing tube is inserted directly into the trachea (airway). This is done if the airway is swollen shut, or if the airway is too swollen to do an endotracheal intubation.
- Antibiotics—Antibiotics given through the veins (IV) help kill the organism causing the infection and swelling. At first, a variety of antibiotics may be given if the identity of the germ is not yet known. Once the laboratory test results are known, a specific antibiotic can be given.
What are the complications of epigliottitis ?The most dangerous complication is respiratory failure (the patient cannot breathe properly, and sometimes not at all) - this is a life-threatening condition.
An infection can spread and otitis media (inner ear infection), meningitis, pericarditis (heart lining infection) and pneumonia can develop.
- Neck x-ray —a test that uses radiation to take a picture of the neck, so the doctor can check for a swollen epiglottis
- Blood culture—to screen for bacteria
- Blood count—to document presence of bacterial infection
- Nasolaryngoscopy—a tiny, lighted tube inserted through the nose to look at structures like the epiglottitis
- Throat culture—A cotton swab is used to collect cells from the infected tissue; the cells are plated on a nutrient-rich medium and allowed to grow. The cells are then identified, and the results are given to the doctor.
- Household members and others who have spent time in the previous 5 out of 7 days with an affected individual
- All day care staff