Epiglottitis

When the epiglottis, a tiny cartilage "lid" that covers the windpipe, expands, it is said to have epiglottitis. The swollen area prevents air from entering the lungs. Epiglottitis may result in death. The epiglottis can enlarge for a variety of reasons. Common causes include throat injuries, infections, and burns from hot drinks.

Anybody can develop epiglottitis at any age. Originally, it was largely understood by kids. Haemophilus influenzae type b (Hib) bacterial infection was the most frequent cause of epiglottitis in youngsters. The bacteria also brings on blood infections, meningitis, and pneumonia. Epiglottitis in children is now uncommon because of the widespread use of the Hib vaccine for babies. It increasingly affects more adults. To avoid fatal consequences, the illness has to be treated right away.

Epiglottitis: Causes

The following are the important causes of developing epiglottitis −

Infection

In the past, infection with the Haemophilus influenzae type b (Hib) bacterium was a frequent cause of swelling and inflammation of the epiglottis and adjacent tissues. Several illnesses, meningitis being the most prevalent, are caused by hib. In affluent nations where children receive the Hib vaccination, Hib is now far less prevalent.

Hib spreads by airborne droplets produced by coughing or sneezing by an infected individual. Hib can be present in the nose and throat without symptoms. It's still possible to distribute it to others, though. Some bacteria and viruses can also make the epiglottis enlarge in adults. They consist of −

• Pneumococcal streptococcus (pneumococcus). Meningitis, pneumonia, ear infections, and blood infections can all be brought on by this bacteria.

• Strep strains A, B, and C. The ailments that this bacterial group can cause range from blood infections to strep throat.

• Aureus Staphylococcus. This bacteria is responsible for toxic shock syndrome, pneumonia, and skin infections.

Injuries

Physical trauma, such as a blow to the throat, can sporadically result in epiglottitis. Inhaling smoke from a fire and swallowing highly hot beverages can cause can burns.

Epiglottitis-like symptoms can result from −

• Ingesting a throat-burning chemical

• Ingesting a thing

• Drug use, such as crack cocaine smoking

• Using electronic cigarettes to smoke

Epiglottitis: Symptoms

The patient with epiglottitis mainly presents with the following symptoms that include −

The Signs in Kids

Epiglottitis symptoms might appear in children within a few hours. Some symptoms include −

• Fever

• Throat pain

• Stridor is a peculiar, high-pitched sound made when breathing in

• Swallowing is uncomfortable and difficult

• Drooling

• Acting agitated

• Leaning forward or sitting up straight to improve breathing

The Signs in Adulthood

Adults may experience symptoms over days as opposed to hours. Some signs might be −

• Throat pain

• Fever

• A husky or muffled voice

• Stridor is a peculiar, high-pitched sound made when breathing in

• Breathing challenges

• Having trouble swallowing

• Drooling

When to Visit a Doctor?

Epiglottitis is a serious medical condition. Dial your local emergency number or get to the emergency room of the closest hospital if you or someone you know suddenly experiences difficulty breathing and swallowing.

Epiglottitis: Risk Factors

Several factors play an important role in the development of epiglottitis which includes −

• The immunological system is being compromised. Bacterial infections that may result in epiglottitis can be more common in people with immune systems that have been compromised by disease or medication.

• Being partially immunized. Children who miss immunizations or wait too long to obtain them run the risk of developing epiglottitis and being susceptible to Haemophilus influenzae type b (Hib).

Epiglottitis: Diagnosis

The diagnosis of epiglottitis is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes −

The medical staff first checks to see if the airway is open and if enough oxygen is flowing through. The group keeps an eye on blood oxygen levels and respiration.

If oxygen levels go too low, breathing assistance may be necessary.

• Tests following a throat examination and steady breathing. A medical professional inspects the throat through the nose using a flexible fiber-optic light tube to determine what is causing the symptoms. The examination might be more pleasant if a numbing agent is administered to the nose. If the airway gets clogged, this might be carried out in an operating room.

• Neck or chest X-ray. X-rays are not required for a diagnosis, but they may help doctors determine whether you have epiglottitis. The X-ray may reveal what seems to be a fingerprint in the neck when epiglottitis is present. This indicates that the epiglottis is expanded.

• Blood tests and throat cultures. A team member tests the tissue sample for Hib after wiping the epiglottis with a cotton swab once breathing has stabilized. Blood infections known as bacteremia can be detected by blood cultures. Epiglottitis frequently coexists with bacteremia.

Epiglottitis: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

• Putting on an oxygen mask. Oxygen enters the lungs through the mask.

• Intubation is the process of inserting a breathing tube into the mouth or nose. The tube remains in place until the neck swelling subsides. This might take many days.

• The procedure of performing a needle cricothyroidotomy in the windpipe. A medical professional could occasionally open an emergency airway. A physician inserts a needle into a cartilage region in the windpipe, also known as the trachea, to swiftly bring air into the lungs.

Infection Treatment

Epiglottitis is treated with antibiotics injected into a vein.

• A multipurpose antibiotic. We must act quickly to address the infection. So, a doctor can order a broad-spectrum medication without waiting for the findings of the blood and tissue cultures.

• More specialized antibiotics. Depending on what is causing the epiglottitis, the first medication may need to be modified later.

Epiglottitis: Prevention

Some of the measures that can help to prevent epiglottitis include −

Hib Vaccine

Epiglottitis brought on by Haemophilus influenzae type b (Hib) can be avoided by receiving the vaccination.

Children often receive the vaccination in three or four doses −

• In two months.

• Four months.

• If the kid is receiving the four-dose immunization, at six months.

• Between 12 and 15 months

Adults and children over the age of five are less prone to get Hib infection, thus they typically do not receive the vaccination. Nevertheless, the Centers for Disease Control and Prevention advises vaccination for older kids and adults with weakened immune systems due to −

• Crohn's disease.

• HIV/AIDS.

• Removing the spleen.

• Chemotherapy.

• Medicine to stop the rejection of bone marrow or organ transplants.

In some patients, there can be some side-effects of vaccines such as an allergic response. Quick medical intervention is necessary for an allergic response.

Conclusion

While epiglottitis is rather uncommon, it is a pretty typical worry in the emergency room. The condition is best addressed by an interprofessional team that includes an intensivist, pulmonologist, infectious disease consult, anesthesiologist, and an ENT surgeon due to its high morbidity and mortality.

ER doctors must be knowledgeable about its presentation and care due to this. The triage nurse and emergency room doctor must be aware of the signs and symptoms of the disease because the majority of patients arrive at the emergency room. The illness has a quick time to cause respiratory discomfort and mortality.