Epiglottitis is the inflammation of the epiglottis—the flap at the base of the tongue that prevents food entering the trachea (windpipe).[7] Symptoms are usually rapid in onset and include trouble swallowing which can result in drooling, changes to the voice, fever, and an increased breathing rate.[1][2] As the epiglottis is in the upper airway, swelling can interfere with breathing.[7] People may lean forward in an effort to open the airway.[1] As the condition worsens, stridor and bluish skin may occur.[1]
Epiglottitis was historically mostly caused by infection by H. influenzae type b (commonly referred to as "Hib").[1] With vaccination, it is now more often caused by other bacteria, most commonly Streptococcus pneumoniae, Streptococcus pyogenes, or Staphylococcus aureus.[1] Predisposing factors include burns and trauma to the area.[1] The most accurate way to make the diagnosis is to look directly at the epiglottis.[3] X-rays of the neck from the side may show a "thumbprint sign" but the lack of this sign does not mean the condition is absent.[1]
An effective vaccine, the Hib vaccine, has been available since the 1980s.[4] The antibiotic rifampicin may also be used to prevent the disease among those who have been exposed to the disease and are at high risk.[5] The most important part of treatment involves securing the airway, which is often done by endotracheal intubation.[1] Intravenous antibiotics such as ceftriaxone and possibly vancomycin or clindamycin is then given.[2][4] Corticosteroids are also typically used.[1] With appropriate treatment, the risk of death among children with the condition is about one percent and among adults is seven percent.[3]
With the use of the Hib vaccine, the number of cases of epiglottitis has decreased by more than 95%.[8] Historically, young children were mostly affected, but it is now more common among older children and adults.[4] In the United States, it affects about 1.3 per 100,000 children a year.[1] In adults, between 1 and 4 per 100,000 are affected a year.[6] It occurs more commonly in the developing world.[9] In children the risk of death is about 6%; however, if they are intubated early, it is less than 1%.[5]
^ abcdefghijklmnopRichards AM (February 2016). "Pediatric Respiratory Emergencies". Emergency Medicine Clinics of North America. 34 (1): 77–96. doi:10.1016/j.emc.2015.08.006. PMID 26614243.
^ abcdeZoorob R, Sidani MA, Fremont RD, Kihlberg C (1 November 2012). "Antibiotic use in acute upper respiratory tract infections". American Family Physician. 86 (9): 817–22. PMID 23113461.
^ abcdWesterhuis B, Bietz MG, Lindemann J (August 2013). "Acute epiglottitis in adults: an under-recognized and life-threatening condition". South Dakota Medicine. 66 (8): 309–11, 313. PMID 24175495.
^ abcdeSchlossberg D (2015). Clinical infectious disease (Second ed.). Cambridge University Press. p. 202. ISBN 9781107038912. Archived from the original on 2016-08-16.
^ abcBlacklow NR (2004). Infectious diseases (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 461. ISBN 9780781733717. Archived from the original on 2016-08-16.
^ abTextbook of Adult Emergency Medicine (4 ed.). Elsevier Health Sciences. 2014. p. 291. ISBN 9780702054389. Archived from the original on 15 August 2016. Retrieved 15 July 2016.
^ abHamborsky j (2015). "Haemophilus influenzae type b". Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases (13 ed.). Public Health Foundation. p. Chapter 8. ISBN 9780990449119. Archived from the original on 20 July 2016. Retrieved 14 July 2016.
^Des Jardins T (2015). Clinical Manifestations & Assessment of Respiratory Disease (7 ed.). Elsevier Health Sciences. p. 529. ISBN 9780323358972. Archived from the original on 2016-08-15.
^Boons GJ (2009). Carbohydrate-Based Vaccines and Immunotherapies. Hoboken: John Wiley & Sons. p. 1222. ISBN 9780470473276. Archived from the original on 2016-08-15.
there is no evidence that this vaccine prevents epiglottitis. There have been many cases of epiglottitis reported in immunocompromised patients, including...
the epiglottis is known as epiglottitis. Epiglottitis is mainly caused by Haemophilus influenzae. A person with epiglottitis may have a fever, sore throat...
laryngoscopy. Other conditions that can produce similar symptoms include epiglottitis, croup, inhaling a foreign body, and laryngeal cancer. The acute form...
needs immediate hospitalization. Epiglottitis is treated with antibiotics. Routine vaccination has made epiglottitis very rare but it still does present...
on signs and symptoms after potentially more severe causes, such as epiglottitis or an airway foreign body, have been ruled out. Further investigations...
in encapsulated type b (Hib), a serotype causing conditions such as epiglottitis, is known to be a major factor in virulence. Their capsule allows them...
and laryngitis are also considered upper respiratory tract infections. Epiglottitis is a bacterial infection of the larynx which causes life-threatening...
indicative of serious airway obstruction from severe conditions such as epiglottitis, a foreign body lodged in the airway, or a laryngeal tumor. Stridor should...
the mouth, tongue, or throat (esophagitis, pharyngitis, tonsillitis, epiglottitis) Oral or throat cancer Phagophobia "odynophagia". The American Heritage...
faster result. Other conditions that can produce similar symptoms include epiglottitis, thyroiditis, retropharyngeal abscess, and occasionally heart disease...
radiologic sign found on a radiograph that suggests the diagnosis of either epiglottitis or intestinal ischemia. In a lateral C-spine radiograph, the sign is...
therefore resulted in a decrease in the rate of meningitis, pneumonia, and epiglottitis. It is recommended by both the World Health Organization (WHO) and the...
Infections such as tonsillitis, retropharyngeal and peritonsillar abscesses, epiglottitis and mumps. Problems with the jaw, e.g., fracture or dislocation Radiation...
complications arising from quinsy, but is now thought to have died from epiglottitis. James Gregory of the band The Ordinary Boys almost died from quinsy...
were on a weekend ski trip at Mammoth Lakes, Christopher suffered acute epiglottitis, going into a coma and cardiac arrest after doctors subsequently carried...
infectious mononucleosis. Other conditions that may present similarly include epiglottitis, Kawasaki disease, acute retroviral syndrome, Lemierre's syndrome, Ludwig's...
forced to exit the show on November 2, 2020, after being diagnosed with epiglottitis, an inflammatory condition that can cause swelling and block airflow...
priority is to secure the patient's airway, and to rule out croup and epiglottitis which may be fatal. Suspicion for tracheitis should be high in cases...
authors, however, largely have concluded that he likely died from severe epiglottitis complicated by the treatments, including multiple doses of calomel, a...
spent a week in the intensive care unit at Cedars Sinai Hospital with epiglottitis. In an interview on The Howard Stern Show in October 2018, Silverman...
Beesley), is called to a patient who is having difficulty breathing due to epiglottitis. Lake calls for emergency assistance but help is slow coming, so fearing...
been suggested that George Washington was treated with Spanish fly for epiglottitis, the condition which caused his death. Currently the cantharidin in US...
Causes are typically obstructive, including foreign bodies, croup, epiglottitis, tumours, infection and anaphylaxis. Appropriate ratio of inspiration...
pharyngitis inflames the pharynx, hypopharynx, uvula, and tonsils. Similarly, epiglottitis (supraglottitis) inflames the superior portion of the larynx and supraglottic...
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