Epiglottitis (eh-pih-glah-TIE-tis) is a condition involving life-threatening swelling of the epiglottis * . It is usually caused by a bacterial infection of the epiglottis and can result in blockage of the windpipe (trachea) and severe breathing difficulty.
Epiglottitis, also known as supraglottitis (su-pra-glah-TIE-tis), is characterized by inflammation and swelling of the epiglottis and other upper airway structures. The epiglottis can become dangerously swollen within just a few hours, leading to narrowing of the airway and severe breathing difficulty.
Epiglottitis is usually caused by bacterial infection. Haemophilus influenzae type B (Hib) bacteria accounted for the majority of cases of epiglottitis before the widespread use of the Hib vaccine. Staphylococcus aureus, Streptococcus pneumoniae, and groups A, B, and C streptococci bacteria; certain viruses; traumatic injuries; scalding; and severe smoke inhalation (causing burns in the upper airway) can also lead to epiglottitis.
People with epiglottitis are hospitalized, usually in intensive care, for several days to a week or more to manage the infection that led to epiglottitis. The time it takes to recover completely varies, depending on the particular infection.
Epiglottitis is most common in children younger than seven years of age. In the United States, cases of epiglottitis declined greatly after the Hib vaccine was introduced in 1985.
Epiglottitis itself is not contagious, but the bacterial infections that can lead to the condition are. As such, the bacteria can spread through person-to-person contact, often in drops of moisture from the respiratory tract when someone sneezes, coughs, or breathes.
Epiglottitis often begins with a sore throat. Symptoms may come on suddenly and include the following:
Because their airways are smaller than those of adults, children with epiglottitis are at greater risk for developing severe breathing problems.
Doctors usually diagnose epiglottitis based on a physical examination and the patient's medical history. If the diagnosis is not clear, a doctor may order an x-ray of the neck to determine whether or not the epiglottis is swollen. Blood cultures or other blood tests may be used to confirm whether a patient has a bacterial or viral infection.
Epiglottitis is a medical emergency that must be treated in a hospital. Ensuring the person is able to breathe is the first and most important response. Often a procedure called intubation (in-too-BAY-shun) is performed, in which a tube is inserted into the windpipe through the mouth or nose to ensure air continues to flow into the lungs. In some cases, an emergency tracheostomy * must be performed to bypass the blocked part of the person's airway.
Intravenous * antibiotics are usually given to combat the infection that led to epiglottitis. Corticosteroid * medication is sometimes given to reduce even further the swelling of the upper airway so the person can breathe more easily. If not treated quickly, epiglottitis can result in complete airway obstruction (air can no longer flow into the lungs) and death.
The best way to prevent epiglottitis is to avoid infection by the bacteria that most commonly cause it with proper hygiene and food sanitation practices. The Hib vaccine, which is part of the routine childhood immunization schedule in the United States, has been extremely successful in decreasing the number of cases of epiglottitis resulting from H. influenzae infection. The Hib vaccine is given as four separate injections (shots) before individuals are two years of age.
See also Influenza • Staphylococcal Infections • Streptococcal Infections • Vaccines and Immunization
Angirekula, Venkata, and Ashrit Multani. “Epiglottitis in an Adult.” New England Journal of Medicine 372 (2015). http://www.nejm.org/doi/full/10.1056/NEJMicm1400061 (accessed October13, 2015).
MedlinePlus. “Epiglottitis.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000605.htm (accessed October 13, 2015).
American Academy of Otolaryngology. 1650 Diagonal Rd., Alexandria, VA 22314-2857. Telephone: 703-836-4444. Website: http://www.entnet.org (accessed November 4, 2015).
American Academy of Pediatrics. 141 Northwest Point Blvd., Elk Grove Village, IL 60007-1098. Telephone: 847-434-4000. Website: https://www.aap.org (accessed October 13, 2015).
* epiglottis (eh-pih-GLAH-tis) is the soft flap of tissue that covers the opening of the trachea (windpipe) when a person swallows to prevent food or fluid from entering the airway and lungs.
* stridor (STRY-dor) is a highpitched, squeaking noise that occurs while breathing in, present usually only if there is narrowing or blockage of the upper airway.
* tracheostomy (tray-kee-AHS-tuhme) is a small opening through the neck into the trachea, or windpipe, which has been made to allow air to enter the lungs more directly. The surgical procedure to create a tracheostomy is usually performed when a person's upper airway is narrowed or blocked or when there are other problems causing breathing difficulty.
* intravenous (in-tra-VEE-nus) or IV, means within or through a vein. For example, medications, fluid, or other substances can be given through a needle or soft tube inserted through the skin's surface directly into a vein.
* corticosteroids (kor-tih-ko-STIRoyds) are chemical substances made by the adrenal glands that have several functions in the body, including maintaining blood pressure during stress and controlling inflammation. They can also be given to people as medication to treat certain illnesses.
* pneumonia (nu-MO-nyah) is inflammation of the lungs.
* meningitis (meh-nin-JY-tis) is an inflammation of the meninges, the membranes that surround the brain and the spinal cord. Meningitis is most often caused by infection with a virus or a bacterium.
* bacteremia (bak-tuh-REE-meuh) is the presence of bacteria in the blood.