What causes epiglottis?

Croup
It is important to differentiate epiglottitis from a less serious condition called croup, which presents with similar symptoms.

Epiglottitis is a potentially life-threatening illness characterized by inflammation of the epiglottis, which is a lid-like structure that covers the opening of the windpipe or trachea. 

What causes epiglottis?

The epiglottis works to close the windpipe when swallowing, preventing choking by blocking food and liquids from entering your airways. When it gets swollen, it can block your airways and make you unable to breathe. Epiglottitis is, therefore, a medical emergency that must be managed in the hospital setting. 

Table: Common causes of epiglottitis
Infection  Diseases
Bacterial (most cases)
  • Haemophilus influenza type b (Hib)
  • Streptococcus pneumonia
Viral (rare)
  • Varicella-zoster virus (which causes chickenpox)
  • Herpes simplex virus (which causes cold sores)
Injury to the throat (seen in adults)
  • A physical blow
  • Drinking a very hot liquid
  • Chemical burns
  • Chemotherapy
  • Cocaine addiction
Fungal infections (seen in people infected with HIV, drug users, or cancer patients)
  • Candida albicans
  • Aspergillus

What are symptoms of epiglottitis?

Symptoms of epiglottitis may include:

Symptoms are often characterized by the 4 Ds:

  • Drooling
  • Distress
  • Dysphagia (inability to swallow food or liquids due to pain)
  • Dysphonia (hoarse voice or inability to speak)

Epiglottitis vs. croup

It is important to differentiate epiglottitis from a less serious condition called croup, which presents with similar symptoms. Croup is a self-limiting illness that does not cause drooling and resolves with nebulization and corticosteroids, unlike epiglottitis which is a more serious condition.

How is epiglottitis diagnosed?

Timely diagnosis and hospitalization are crucial to prevent complications and potential death in cases of epiglottitis. Your doctor may conduct the following tests to confirm a diagnosis:

  • Laryngoscopy involves inserting a laryngoscope (instrument with a small camera and light) into the throat to check for signs of the condition.
  • A throat swab is taken to test for bacteria or viruses.
  • Blood tests check the white blood cell count and the type of germ infecting the throat.

How is epiglottitis treated?

Epiglottitis must be treated in the hospital as a medical emergency:

  • Oxygen mask: Pumps air into the lungs.
  • Intubation: If air passages are severely blocked, a tube is placed in the throat and pushed past the swelling to pump oxygen into the lungs.
  • Tracheostomy: Involves making a cut in the windpipe and inserting a breathing tube past the swelling in the throat to help with breathing.
  • Intravenous (IV) infusion: Maintains fluid and electrolyte levels
  • Antibiotics: Fight off bacterial infection.

SLIDESHOW

Bacterial Infections 101: Types, Symptoms, and Treatments See Slideshow

Can epiglottitis be prevented?

Vaccination against Haemophilus influenzae type B (Hib) bacteria is the most important measure in preventing epiglottitis in a child. It is advised to vaccinate infants 2-6 months of age in either one of the following:

  • 3-dose series of Hib PRP-T as ActHib®, Hiberix® or Pentacel® 4 weeks apart
  • 2-dose series of Hib PRP-OMP as PedvaxHib® followed by a booster dose at 12-15 months.

Adults and children over the age of 5 typically do not require the Hib vaccine, but it is recommended for those who have:

Since Hib vaccine recommendations are made on a case-by-case basis, talk to your doctor about your options.

  • Other precautions to prevent infection include the following:
  • Wash your hands frequently.
  • Avoid touching your eyes, nose, and mouth.
  • Maintain distance around people who are coughing and sneezing.
  • Avoid injuring your throat with hot liquids or smoking.
  • Avoid sending children to school or daycare centers if there has been an outbreak

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Medically Reviewed on 6/29/2021
References
https://my.clevelandclinic.org/health/diseases/17844-epiglottitis#:~:text=Epiglottitis%20is%20usually%20caused%20by,the%20bacteria%20coughs%20or%20sneezes.

https://www.cdc.gov/vaccines/vpd/hib/hcp/recommendations.html