Epiglottitis is a bacterial or viral infection that causes serious medical complication. Epiglottitis is the medical term given for the inflammation of small flesh like organ (epiglottis) present at the base of your tongue. Inflammation of epiglottis can cause life threatening situations in children. The main function of this organ is to prevent passage of food particles into the windpipe. However when this tissue gets swollen it can block and obstruct the airway passage causing choking and even death. Epiglottitis rarely occurs on adults but children are at risk for developing this complex condition due to infection leading to closing off windpipe.
Epiglottitis Symptoms :
Swelling of epiglottis can cause symptoms including sore throat, change in voice, difficulty in eating and speaking. For some children it can cause upper respiratory tract infection, breathing difficulties and choking due to closure of windpipe. It can cause rapid heart rate warranting medical emergency. Children with swelling of epiglottitis can be seen breathing through the mouth and the symptoms may improve when they are allowed to sit upright or in leaning position.
It is quite common to ignore these symptoms since they are often misunderstood for sore throat. But any delay in getting epiglottitis treated can cause death. In adults epiglottitis can cause raspy voice, breathing difficulty, sore throat, noisy breathing and choking. For both children and adults, epiglottitis should be treated on emergency basis to prevent mortality.
Causes Of Epiglottitis :
- Epiglottitis is the result of bacterial infection. Haemophilus influenzae is the common type of bacteria that causes epiglottitis. Bacteria can easily enter into the nasal cavity as one breathes in. It can also spread from infectious person when he/she coughs or sneezes the bacteria would easily enter your nose.
- Strep throat can lead to epiglottitis and hence Streptococcus pneumoniae and other strep infections can cause this problem.
- Viral infections like chicken pox and shingles can also cause epiglottitis. Some other causes of epiglottitis include smoking of cocaine, severe throat injury or trauma from a gunshot and burning of throat.
Risk Factors :
- Epiglottitis can affect anybody irrespective of age but children are more prone than adults. Infants and young children below 4 years are at increased risk of epiglottitis. Children who have not got vaccine for Hib are at high risk.
- Some doctors believe that more males than females are developing epiglottitis for reasons unknown.
- Children and adults living in smoke prone environment and heavily populated atmosphere are at increased risk of catching germs. Children infected with bacteria or virus should not be sent to day care centers since they are likely to transmit the infection to other children.
- Anyone whose immunity is weak is prone to develop epiglottitis.
Epiglottitis Tests :
Often, the condition of epiglottitis goes unnoticed, until it becomes severe. Diagnosis would be done in emergency setting. The doctors would observe the physical symptoms and starts giving remedial measures to support breathing. Throat examination would be done using fiber optic tubing if the doctor suspects epiglottitis. Imaging tests like chest and throat X-ray can be done to check the extent of inflammation of the throat. If required, your doctor may order for blood culture to determine the nature of bacteria/virus.
Epiglottitis Treatment :
Treatment is given on emergency room to restore normal breathing. The doctor/nurses in the emergency room will monitor the oxygen levels first using oximeter. Based on the condition of the patient, he/she would be given supplemental oxygen with breathing tube. Antibiotics are given intravenously for arresting bacterial growth and infection. IV fluids are started for balancing the fluid levels if the patient has difficulty in swallowing. If necessary corticosteroids are given for treating swelling of throat. In severe cases, minor surgery (tracheotomy) for restoring normal respiration and to clear off the closed trachea. The patient can be recovered to normalcy if the treatment is started in time.
How To Prevent Epiglottitis ?
Giving Hib Haemophilus influenza vaccine at regular intervals is the only way to prevent epiglottitis in children. First dosage begins when the infant is of 2 months old and booster doses are given in scheduled time when the child is 1-1.5 years old. Parents should maintain the chart and visit the clinic to get scheduled doses of Hib for their children. Children should be instructed to wash their hands properly before eating and after using the toilet. Instruct them to cover their noses and mouth while coughing and sneezing to prevent spread of infection. Parents should not send their child to day-care center if they are infected and having fever or cold.
Prognosis :
Any individual (child or adult) can fully recover from epiglottitis if treatment is given in right time. Chances of survival are poor if there is delay in diagnosing the problem and delay in giving treatment.