Epiglottitis - Symptoms, Diagnosis, and Treatment

What Is Epiglottitis?

Epiglottitis is a condition in which the epiglottis (a small flap located at the back of the tongue) becomes swollen and inflamed. Under normal circumstances, the epiglottis functions as a lid. It closes over the windpipe when you are swallowing, preventing food and liquids from going into the lungs.

When the epiglottis inflames, it may close off the airway. This makes it extremely difficult to breathe. Epiglottitis is serious because it may become worse rapidly. If left untreated, it can be fatal. Doctors view epiglottitis as an emergency. Anyone who suddenly experiences difficulty breathing, drooling, or a voice that sounds muffled should seek attention immediately.

How Common Is It?

Prior to vaccines, epiglottitis was prevalent among young kids. The Hib vaccine (Haemophilus influenzae type b) has made it less frequent today. Today, it is not frequent in children but can still occur in adults. In adults, other bacteria, viruses, or throat trauma are typically the culprit.

Who Is at Risk for Epiglottitis?

Epiglottitis can occur in anyone. But some populations have a greater risk:

• Unvaccinated children are at greatest risk.

• Adults with compromised immune systems, such as those with chronic disease.

• Individuals who smoke or take drugs that irritate the throat.

• Individuals who are exposed to burns or trauma in the throat, such as from eating hot foods or toxic chemicals.

What Does Epiglottitis Look Like?

Epiglottitis is visible on a physical examination of the throat. Physicians recommend epiglottitis images, X-rays, or a radiology scan to verify the swelling.

Physicians will observe:

• A red, inflamed epiglottis.

• A patient sitting up, leaning forward to breathe.

• Excessive drooling due to pain with swallowing.

• Stridor, or a high-pitched sound on breathing.

• Muffled, hoarse, or "hot potato" voice.

Epiglottitis Causes

The etiology of epiglottitis varies between children and adults. Although bacterial epiglottitis is the most dangerous, non-infectious causes can also be dangerous since swelling may occlude the airway. ​Typical etiology involves:

• ​Bacterial infections, including Streptococcus pneumoniae and Staphylococcus aureus.

• Hib (most prevalent in the past).

• ​Viral infections, such as the flu or upper respiratory tract disease.

• ​May accompany croup and epiglottitis (infections of the upper airway).

• ​Injuries to the throat.

• ​Swallowing sharp objects such as fish bones.

• ​Ingestion of very hot beverages.

• ​Chemical burns.

• ​Allergic reactions.

​Epiglottitis Signs And Symptoms

Symptoms in Children

Children develop symptoms suddenly. ​Epiglottitis symptoms in children are extremely risky and require urgent treatment. They appear to be very ill within a few hours.

​Common symptoms include:

• ​Sudden high fever.

• ​Severe sore throat.

• Difficulty swallowing.

• ​Drooling (since they can't swallow saliva).

• ​Stridor (noisy breathing).

• ​Sitting up and leaning forward.

• ​Restlessness and fear.

• ​Pale or blue skin indicates that the oxygen level is low.

​Symptoms in Adults:

Adults usually develop symptoms more slowly, but they are no less serious. Even though they begin as mild symptoms, they may turn life-threatening within hours. Adult symptoms include:

• Severe sore throat.

• Throat pain on swallowing food or water.

• Muffled, hoarse voice.

• Fever and chills.

• Difficulty breathing.

• Sensation of something being lodged in the throat.

• Drooling in extreme cases.

Epiglottitis Diagnosis And Tests

Doctors make the diagnosis of epiglottitis cautiously because examination of the throat may exacerbate swelling. However, the diagnosis must be done quickly. The priority is to stabilize the airway first, followed by establishing the cause. The patient should be in a secure hospital environment.

Diagnostic procedures include:

• Physical examination to examine the posture, voice, breathing, and drooling.

• The thumb sign on a side neck X-ray indicates that the epiglottis is swollen like a thumb.

• Epiglottitis radiology tests and imaging to confirm the swelling.

• Blood work and throat culture to identify the bacteria or virus that is causing the infection.

• Laryngoscopy is performed by inserting a very thin tube with a camera to view the inner structures. It is done only when the airway assistance is imminent.

Epiglottitis Treatment

Epiglottitis must be treated swiftly in a hospital setting. The initial step is to ensure that the patient can breathe. Patients are commonly kept in the intensive care unit, where around-the-clock monitoring is done to avoid instant airway shutdown. Epiglottitis treatment can save lives, but early treatment is essential. Delayed treatment is fatal.

Epiglottitis Treatment Steps:

• Airway assistance.

• Oxygen should be given by a mask.

• A breathing tube is used in severe cases.

• Sometimes, a tracheostomy (an operative opening in the throat) is performed if the airway is obstructed.

The following medicines are recommended:

• Antibiotics for bacterial epiglottitis.

• Corticosteroids to minimize swelling

• IV (intravenous) fluids to prevent dehydration because swallowing is difficult.

• Painkillers and fever reduction.

• Hospitalization.

Epiglottitis Complications

Despite treatment, complications are possible, making hospital care essential. Without treatment, epiglottitis can cause serious complications such as:

• Blockage of the airway is the most severe complication.

• Respiratory failure: lungs may fail due to obstructed breathing.

• Sepsis occurs due to bacteria spreading through the blood, causing a life-threatening infection.

• Pneumonia occurs due to bacterial lung infection.

• Death may occur within hours without treatment.

Epiglottitis Prevention

Prevention is most effective along with vaccination and maintaining healthy daily routines. Certain preventive measures can significantly reduce the risk of epiglottitis. These include:

• Vaccination: The Hib vaccine is highly effective against Hib epiglottitis. Children usually receive it as part of routine childhood immunizations.

• Good hygiene: Wash hands frequently. Avoid sharing utensils or beverages or close contact with sick individuals.

• Avoid throat trauma: Be careful with very hot foods or liquids, and avoid small, sharp foods like fish bones.

• Quit smoking: Smoking inflames the throat and increases the risk of infection.

• Control allergies: Keep allergy medications ready to prevent severe swelling.

When to See a Doctor?

Seek emergency care immediately if you or your child has:

• Sudden breathing difficulty.

• Trouble swallowing or excessive drooling.

• Stridor (loud, high-pitched breathing sound).

• Sitting up with your chin forward while breathing.

• Severe sore throat with a very high fever.

• Do not attempt to examine the throat at home, as this may worsen swelling. Call emergency medical services immediately.

Conclusion

Epiglottitis is an uncommon but serious disease. It occurs when the epiglottis, the cover over the windpipe, swells up. This closing of the airway prevents breathing. It may be caused by bacteria, viruses, throat traumas, or allergic reactions. The disease affects children quickly, whereas adults take longer to show signs. Diagnosis involves medical examination, e.g., epiglottitis, X-ray, or cultures. Epiglottitis is treated with oxygen, antibiotics, corticosteroids, and hospitalization. Prevention by the use of the Hib vaccine, good hygiene, and avoidance of throat injury is very effective. Epiglottitis is always an emergency. Early identification and immediate medical intervention can save lives.

Key Takeaway

• Epiglottitis is inflammation of the epiglottis that obstructs the airway.

• It is currently uncommon because of the Hib vaccine, but it can still be harmful.

• Symptoms are a sore throat, drooling, noisy respiration, and a muffled voice.

• Epiglottitis treatment with antibiotics and respiratory support needs to be initiated immediately.

• Prevention of epiglottitis with vaccination and good hygiene is optimal protection.

• For further information and custom suggestions, you can contact our doctors at icliniq.com.