What is epiglottitis?

Epiglottitis is a serious condition that causes inflammation and swelling of the epiglottis, the section of tissue at the top of the trachea. When a bacterial infection, virus, or throat injury damages the epiglottis, it becomes very difficult to breathe and swallow. Life-threatening respiratory failure can occur if epiglottitis is not diagnosed and treated in its early stages. Emergency breathing tubes, oxygen therapy, and anti-inflammatory drugs are usually needed to prevent fatal complications.

Most cases of epiglottitis are caused by bacteria called Haemophilus influenzae, a widespread pathogen that usually doesn't cause problems in healthy people. People with weakened immune systems, especially very young children, are at greatest risk of Haemophilus influenzae infection and posterior epiglottitis. Many other pathogens can also cause infection, including bacteria from the streptococcus family and the herpes simplex virus. Less commonly, accidentally swallowing an irritant, smoking illicit drugs, or getting hit in the throat can cause serious irritation.

The epiglottis is made up of flexible cartilage tissue that folds up and down during breathing to allow air to pass through the trachea. When the tissue becomes inflamed, the epiglottis becomes swollen and cannot bend properly. Initial symptoms of epiglottitis may include a low-grade fever, difficulty breathing deeply, and a sore throat. As the inflammation worsens, swallowing becomes painful and breathing becomes very shallow. Respiratory failure is almost certain if the epiglottis swells enough to completely block the trachea.

A person showing signs of epiglottitis should be taken to the emergency room as soon as possible. If the airway restriction is severe, a doctor may insert a breathing tube to prevent respiratory failure. Oxygen may need to be given if the trachea is partially open but breathing is still shallow. Once the patient is stabilized, imaging tests are performed to measure the severity of the damage to the epiglottis and surrounding tissue. Samples of blood and throat tissue are collected and tested to determine the bacteria or viruses responsible for the symptoms.

After identifying the underlying cause and relieving breathing difficulties, a doctor may administer intravenous antibiotics and anti-inflammatory medications. A patient usually stays in the hospital for several days so that doctors can carefully monitor her recovery. Once the patient begins to feel better, oral medications are prescribed to be taken daily for one to two weeks and a follow-up exam is scheduled. With prompt treatment, most children and adults make full recoveries from epiglottitis.

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