EPIGLOTTITIS, ACUTE

General Information

DEFINITION--A sudden, life-threatening childhood infection of the epiglottis (a small flap of tissue in the back of the throat that guards the airway entrance to the lung). Epiglottitis is contagious and is often confused with croup, which is less serious.

BODY PARTS INVOLVED--Epiglottis and surrounding tissue.

SEX OR AGE MOST AFFECTED--Children (2 to 12 years).

SIGNS & SYMPTOMS

• Muffled voice or cry (in croup it is more hoarse).
• Minimal cough (in croup it is a barking cough).
• Sore throat.
• Fever.
• Hoarseness.
• Drooling caused by difficulty swallowing saliva.
• Increasing breathing difficulty.
• Noisy, high-pitched, squeaky inhalations.
• Purple skin and nails.
• Odd head posture. The child tilts the neck back and leans forward with the tongue stuck out and the nostrils flared, trying to inhale more air.

CAUSES--Infection of the epiglottis by a bacteria (usually hemophilus influenza, pneumococcus or streptococcus). The swollen epiglottis blocks the trachea (the main lung airway).

RISK INCREASES WITH

• Illness that has lowered resistance.
• Crowded or unsanitary living conditions.

HOW TO PREVENT

• If your child has had epiglottitis previously, treat all respiratory infections early and with medical supervision.
• Immunize children against hemophilus influenza.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood culture, throat culture and others that are performed under special controls to prevent complications.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for oxygen and other intensive care.
• Surgery to make an opening in the windpipe (trachea) or to place a tube in the trachea to permit breathing. Usually the tube is withdrawn or the opening is closed in 4 to 7 days.

POSSIBLE COMPLICATIONS--Without treatment, complete airway obstruction and death within hours.

PROBABLE OUTCOME--Full recovery with prompt diagnosis and treatment.

How To Treat

GENERAL MEASURES--

• Caution--Never attempt to look at back of child's throat if you suspect epiglottitis.
• Have the child sit up rather than lie down.
• Keep the child calm and still until reaching the hospital. Panic increases breathing difficulty.
• After hospitalization, use a cool-mist ultrasonic humidifier at night in the child's room for 2 to 3 weeks. Clean humidifier daily.

MEDICATION--Your doctor may prescribe antibiotics to control infection. Continue for a minimum of 10 days.

ACTIVITY--Bed rest is necessary until all symptoms disappear. Activities may then be resumed gradually.

DIET--Fluids only (usually intravenous) until the child can swallow. After hospitalization, encourage extra fluids and provide a normal diet.

Call Your Doctor If

• Your child has symptoms of epiglottitis, especially signs of breathing difficulty. This is an emergency!
• Your child has had epiglottitis in the past, and symptoms of respiratory infection appear.