What is epiglottitis?
Epiglottitis is an acute life-threatening bacterial infection that causes swelling and inflammation of the epiglottis. The epiglottis is an elastic cartilage structure at the base of the tongue. It prevents food from entering the windpipe (trachea) when swallowing. Epiglottitis makes it hard to breathe, and it progresses quickly. If not treated, it can be life-threatening. That’s because there is so much swelling that air can’t get in or out of the lungs.
This condition most often affects children between 2 and 6 years old.
What causes epiglottitis?
The main cause of epiglottitis is a bacterial infection that can be spread through the upper respiratory tract. The bacteria usually is Haemophilus influenzae type B (HIB). Another bacteria that can cause epiglottitis is group A ß-hemolytic streptococci. Experts don’t fully understand why some children get the disease, while others do not. A vaccine to help prevent epiglottitis is recommended for all children beginning at age 2 months.
What are the symptoms of epiglottitis?
Each child’s symptoms may vary. In some children, symptoms of epiglottitis begin with symptoms of an upper respiratory infection. Symptoms may include:
Sudden onset of a very sore throat
Blue skin coloring (cyanosis)
A high-pitched sound that is usually noted as the child breathes in (stridor)
As the disease gets worse, the following symptoms may appear:
Unable to talk
The child sits leaning forward
The child keeps his or her mouth open
The child is distressed or anxious
How is epiglottitis diagnosed?
Epiglottitis is an emergency. The main concern with suspected epiglottitis is to make sure your child is able to breathe. Your child will likely be hospitalized so that breathing can be managed. Once breathing is established, your child’s healthcare provider will visualize the airway. Usually this is enough to confirm epiglottitis. In some cases, a laryngoscopy or X-ray may be done.
Don’t try to try to examine your child's throat at home. This can cause further swelling which may block the airway entirely.
How is epiglottitis treated?
The treatment for epiglottitis requires immediate emergency care to prevent complete blockage of the airway. Epiglottitis progresses rapidly. A breathing tube will be put in place right away and the child's airway will be closely monitored. If needed, the child's breathing will be assisted with machines.
IV (intravenous) therapy with antibiotics will be started immediately. This will help treat the infection by the bacteria. Treatment may also include:
Steroid medicine (to reduce airway swelling)
IV fluids, until the child can swallow again
How well the child recovers from this disease is related to how quickly treatment begins in the hospital setting. Once the child is being watched, the airway is safe, and antibiotics are started, the disease usually stops progressing within 24 hours. Complete recovery takes longer and depends on each child's condition.
Can epiglottitis be prevented?
As mentioned above, epiglottitis caused by the bacteria HIB can be prevented with vaccines that start at the age of 2 months. Epiglottitis caused by other organisms can’t be prevented at this time, but is much less common.
To help prevent epiglottitis, the CDC recommends infants receive 3 to 4 doses of the HIB vaccine. Primary doses are given at 2 and 4 months of age or at 2, 4, and 6 months of age, based on the brand used by the healthcare provider’s office. A booster dose is given by 12 to 15 months of age.
The HIB vaccine protects against this bacteria. This decreases the chance of developing epiglottitis.
If a child is diagnosed with epiglottitis, the child's family or other close contacts are usually treated with a medicine called rifampin. This is done to prevent the disease in those people who might have been exposed.