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Epiglottitis

epiglotitis

The epiglottis is a leaf-shaped flap of cartilage tissue that lies just behind the root of your tongue. When you swallow, your epiglottis covers your larynx ( voicebox) stopping food from entering your trachea (windpipe).

What is epiglottitis and what causes it?

Epiglottitis is inflammation of the epiglottis. It is almost always caused by a bacterial infection. The most common bacterium that causes epiglottitis is Haemophilus influenzae type b (Hib). Other bacteria such as Streptococcus pneumoniae can also cause epiglottitis.

Infection leads to inflammation and swelling of the epiglottis. If the epiglottis swells, because of its position in your throat, it can affect your breathing by obstructing (blocking) the passage of air through your larynx to your trachea and your lungs.

Who gets epiglottitis and how common is it?

Epiglottitis can occur at any age but it most commonly affects children between the ages of two and seven. As the use of the Hib vaccine increases, this has meant that the typical person who develops epiglottitis is an adult rather than a child.

What are the symptoms of epiglottitis?

Fever (high temperature) is usually the first symptom. Someone with epiglottitis will also complain of a very sore throat. They may have a hoarse voice and pain on swallowing. Because of the pain on swallowing, they may drool saliva. Coughing is a less common symptom. Noisy breathing and breathing difficulty then follow and need to be treated quickly. Someone with epiglottitis usually prefers to sit upright and lean slightly forwards, often with their tongue protruding (sticking out).

How is epiglottitis diagnosed?

If someone has suspected epiglottitis, they should be admitted to hospital immediately. It should be treated as an emergency. Epiglottitis is usually diagnosed by the typical symptoms. A procedure called a nasopharyngoscopy may be used, once you are in hospital, to help confirm epiglottitis. A thin flexible tube is run down your nose into your throat. The doctor is able to see through the tube and look for swelling or redness of the epiglottis.

Sometimes an X-ray of your neck is taken and this can show a swollen epiglottitis.

What is the treatment for epiglottitis?

If someone has epiglottitis, the most important treatment is to ensure that they are getting enough oxygen into their lungs. For example, oxygen can be given using a mask over their mouth and nose. Sometimes someone may need help with their breathing, using a ventilator.

In severe cases, if the epiglottis is swollen and blocking the airway, even if oxygen is given, it would not be able to reach the lungs. So, a procedure called a tracheostomy is done. This is where a small cut is made in the trachea (windpipe). This allows a tube to pass below the swollen epiglottis so that oxygen can be delivered to the lungs. Someone with a tracheostomy may also need help with their breathing using a ventilator.

Antibiotics are another important part of the treatment. They help to fight the infection. A steroid medicine may also be given to help reduce the inflammation around the epiglottis.

Are there any complications of epiglottitis?

If epiglottitis is not treated quickly, the airway can become totally blocked. This means that air is not able to get into the lungs and the person can die. However, if epiglottitis is treated quickly, the outlook is generally very good. Recovery usually takes about seven days in children and may be a little longer in adults.

Can epiglottitis be prevented?

The Hib vaccine is advised for all babies at age two, three, four and 12 months. This has led to a dramatic reduction in cases of epiglottitis in children. However, as with all vaccines, it is not always 100% effective. Epiglottitis may also be caused by other bacteria. Close contacts of someone who has been diagnosed with epiglottitis are also usually given antibiotics to help to reduce the chance of them developing the infection


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