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Epiglottitis

What is epiglottitis?

Epiglottitis is characterized by inflammation and swelling of your epiglottis. It’s a potentially life-threatening illness.

The epiglottis is at the base of your tongue. It’s made up of mostly cartilage. It works as a valve to prevent food and liquids from entering your windpipe when you eat and drink. The tissue that makes up the epiglottis can become infected, swell, and block your airway. This requires immediate medical attention. If you think that you or someone else has epiglottitis, call 911 or seek emergency medical help immediately.

Epiglottitis is historically a condition more common in children, but it’s becoming more frequent in adults. It requires prompt diagnosis and treatment in anyone, but especially in children, who are more vulnerable to breathing complications.

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Causes

What causes epiglottitis?

A bacterial infection is the most common cause of epiglottitis. Bacteria can enter your body when you breathe it in. It can then infect your epiglottis.

The most common strain of bacteria that causes this condition is Haemophilus influenzae type b, also known as Hib. You can catch Hib by inhaling the germs spread when an infected person coughs, sneezes, or blows their nose.

Other bacterial strains that can cause epiglottitis include Streptococcus A, B, or C and Streptococcus pneumoniae. Streptococcus A is the type of bacteria that can also cause strep throat. Streptococcus pneumoniae is a common cause of bacterial pneumonia.

Additionally, viruses such as those that cause shingles and chickenpox, along with those that cause respiratory infections, can also result in epiglottitis. Fungi, such as those that cause diaper rash or yeast infections, may also contribute to inflammation of the epiglottis.

Other causes of this condition include:

  • smoking crack cocaine
  • inhaling chemicals and chemical burns
  • swallowing a foreign object
  • burning your throat from steam or other sources of heat
  • experiencing throat injury from trauma, such as a stabbing or gunshot wound

Risk factors

Who is at risk for epiglottitis?

Anyone can develop epiglottitis. However, several factors can increase your risk of developing it.

Age

Children younger than 12 months of age are at a higher risk for developing epiglottitis. This is because these children haven’t yet completed the Hib vaccine series. Overall, the disease commonly occurs in children ages 2 to 6 years. For adults, being older than 85 years is a risk factor.

Additionally, children who live in countries not offering vaccines or where they’re hard to come by are at increased risk. Children whose parents choose not to vaccinate them with the Hib vaccine are also at increased risk for epiglottitis.

Sex

Males are more likely to develop epiglottitis than females. The reason for this is unclear.

Environment

If you live or work with a large number of people, you’re more likely to catch germs from others and develop an infection. Likewise, heavily populated environments such as schools or day care centers may increase your or your child’s exposure to all types of respiratory infections. The risk of getting epiglottitis is increased in those environments.

Weak immune system

A weakened immune system can make it more difficult for your body to fight infections. Poor immune function makes it easier for epiglottitis to develop. Having diabetes has been shown to be a risk factor in adults.

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Symptoms

What are the symptoms of epiglottitis?

The symptoms of epiglottitis are the same regardless of the cause. However, they may differ between children and adults. Children can develop epiglottitis within a matter of hours. In adults, it often develops more slowly, over the course of days.

The symptoms of epiglottitis that are common in children include:

  • a high fever
  • lessened symptoms when leaning forward or sitting upright
  • sore throat
  • a hoarse voice
  • drooling
  • difficulty swallowing
  • painful swallowing
  • restlessness
  • breathing through their mouth

Symptoms common in adults include:

  • fever
  • difficulty breathing
  • difficulty swallowing
  • a raspy or muffled voice
  • harsh, noisy breathing
  • a severe sore throat
  • an inability to catch their breath

If epiglottitis is untreated, it can block your airway completely. This can lead to bluish discoloration of your skin due to lack of oxygen. This is a critical condition and requires immediate medical attention. If you suspect epiglottitis, seek medical attention immediately.

Diagnosis

How is epiglottitis diagnosed?

Due to the seriousness of this condition, you may receive a diagnosis in an emergency care setting simply by physical observations and a medical history. In most cases, if your doctor thinks you might have epiglottitis, they’ll admit you into the hospital. Once you’re admitted, your doctor may perform any of the following tests to support the diagnosis:

  • X-rays of your throat and chest to view the severity of the inflammation and infection
  • throat and blood cultures to determine the cause of infection, such as bacteria or a virus
  • a throat examination using a fiber optic tube
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Treatment

What is the treatment for epiglottitis?

If your doctor thinks you have epiglottitis, the first treatments typically involve monitoring your oxygen levels with a pulse oximetry device and protecting your airway. If your blood oxygen levels become too low, you’ll likely get supplemental oxygen through a breathing tube or mask. Your doctor may also give you one or all of the following treatments:

  • intravenous fluids for nutrition and hydration until you’re able to swallow again
  • antibiotics to treat a known or suspected bacterial infection
  • anti-inflammatory medication, such as corticosteroids, to reduce the swelling in your throat

You may also need a minor surgical procedure known as a tracheotomy, used only for severe cases. During this procedure, your doctor inserts a needle into your trachea. This allows exchange of oxygen and prevents respiratory failure.

If you seek immediate medical attention, you can expect a full recovery in most cases.

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Prevention

Can epiglottitis be prevented?

You can help reduce the risk of getting epiglottitis by doing several things.

Children should receive two to three doses of the Hib vaccine starting at 2 months of age. Typically, children receive a dose when they are 2 months, 4 months, and 6 months old. Your child will likely also receive a booster between 12 and 15 months old.

Wash your hands frequently or use alcohol sanitizer to prevent the spread of germs. Avoid drinking from the same cup as other people and sharing food or utensils. Maintain good immune health by eating a proper diet, avoiding smoking, getting adequate rest, and properly managing all chronic medical conditions.

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