Epiglottitis

Your throat is a complex area with several important parts: the esophagus (food tube), trachea (windpipe), larynx (voice box), tonsils, and epiglottis.

The epiglottis is a small, flap-like piece of cartilage that acts like a lid over the windpipe. When the epiglottis swells up, it blocks the airway, preventing air from getting to your lungs. This is a serious condition called epiglottitis, and it can be life-threatening.

Several things can cause the epiglottis to swell. These include infections (like bacterial or viral illnesses), burns from drinking something too hot, or injuries to the throat.

Epiglottitis can affect people of any age, but it used to be more common in children. In the past, a bacteria called Haemophilus influenzae type b (Hib) was a frequent cause of epiglottitis in kids. This same bacteria can also cause pneumonia, meningitis (inflammation of the brain and spinal cord lining), and bloodstream infections.

Thankfully, a common vaccine for infants, called the Hib vaccine, has drastically reduced the number of cases of epiglottitis in children. Now, epiglottitis is more often seen in adults. Because it's so serious, getting medical attention quickly is crucial to prevent dangerous problems from developing.

Epiglottitis is a serious illness that needs immediate medical attention. It's an infection that can quickly affect the airway, making breathing difficult.

Symptoms in children often appear very quickly, within a few hours. These can include:

• Fever: A high temperature.
• Sore throat: Pain in the throat.
• Stridor: A noisy, high-pitched sound when breathing in. Imagine a whistling or strained sound.
• Trouble swallowing: Difficulty eating or drinking. This can be very painful.
• Drooling: Increased saliva production.
• Anxiety and irritability: The child may seem upset and uncomfortable.
• Trying to sit up or lean forward: These positions often help a child breathe more easily.

Adults may develop symptoms over a few days rather than hours. Symptoms might include:

• Sore throat: Pain in the throat.
• Fever: A high temperature.
• Muffled or hoarse voice: A change in the voice's tone.
• Stridor: A noisy, high-pitched sound when breathing in.
• Difficulty breathing: Problems with breathing, such as shortness of breath.
• Difficulty swallowing: Problems eating or drinking.
• Drooling: Increased saliva production.

Epiglottitis is a medical emergency. If you or someone you know suddenly has trouble breathing or swallowing, call emergency services immediately (e.g., 911 in the US or your local equivalent) or go to the nearest hospital emergency room. While waiting for help, try to keep the person calm and sitting up or leaning slightly forward. This position can help them breathe more easily. Do not try to give them anything to eat or drink.

Epiglottitis is a serious medical problem that needs immediate attention. If you or someone you know suddenly can't breathe easily or swallow, act quickly. Call 911 or your local emergency number, or take them to the nearest hospital emergency room right away. Help the person stay calm and sit them up straight. This position can help them breathe more comfortably.

Epiglottitis happens when an infection or injury causes the epiglottis (a small flap of tissue at the back of the throat) to swell and become inflamed.

In the past, a common cause of epiglottitis was a bacteria called Haemophilus influenzae type b (Hib). This bacteria also causes other illnesses, like meningitis. Thankfully, Hib infections are much less common in developed countries now. This is mainly due to the widespread use of Hib vaccines in childhood.

Hib is spread through tiny droplets released when an infected person coughs or sneezes. Importantly, someone can carry Hib bacteria in their nose and throat without showing any symptoms, meaning they can still spread the infection.

While Hib was a major cause of epiglottitis in the past, other bacteria and viruses can cause it in adults. These include:

• Streptococcus pneumoniae (pneumococcus): This bacteria can cause various illnesses, including meningitis (infection of the lining around the brain and spinal cord), pneumonia (infection of the lungs), ear infections, and blood infections.
• Streptococcus A, B, and C: This group of bacteria can cause a range of illnesses, from strep throat to serious blood infections.
• Staphylococcus aureus: This bacteria can cause skin infections, pneumonia, and even a life-threatening condition called toxic shock syndrome.

In some cases, epiglottitis can be caused by physical injury. For example, a blow to the throat, burns from drinking extremely hot liquids, or inhaling smoke from a fire can all lead to epiglottitis.

Other less common causes of symptoms that can mimic epiglottitis include:

• Swallowing chemicals that burn the throat: This could be cleaning products, or other corrosive substances.
• Swallowing foreign objects: Such as small toys or coins.
• Smoking drugs like crack cocaine: The act of smoking these drugs can physically damage the throat and surrounding tissues.
• Smoking electronic cigarettes: While less common than other causes, the heat and chemicals in e-cigarette vapor can also irritate the throat and potentially cause inflammation.

It's crucial to seek medical attention immediately if you think you or someone you know might have epiglottitis. The symptoms can be serious and require prompt medical treatment.

Epiglottitis is a serious condition that can affect the airway. Several things can increase the chances of getting it.

One factor is a weakened immune system. Your immune system is your body's defense against germs. If your immune system is already battling an illness or is weakened by medicines, it might not be able to fight off infections as well. This means you're more likely to get a bacterial infection, and one of those infections can lead to epiglottitis.

Another important factor is not being fully vaccinated. Vaccinations help protect you from certain diseases. If you don't get the recommended vaccinations, or if you don't get them on schedule, your body might not have the protection it needs. In the case of epiglottitis, not being fully vaccinated can leave you vulnerable to infections, like Haemophilus influenzae type b (Hib), which can cause the condition.

Epiglottitis, a serious illness, can lead to several dangerous complications.

Difficulty Breathing (Respiratory Failure):

The epiglottis is a small flap of tissue located above your voice box (larynx). It acts like a lid, preventing food and liquids from going down the wrong pipe (your windpipe). When epiglottitis causes the epiglottis to swell, it can completely block the airway. This blockage stops you from getting enough air into your lungs. If this happens, your body doesn't get the oxygen it needs, which can quickly become life-threatening. This is called respiratory failure. With respiratory failure, the amount of oxygen in your blood drops dangerously low.

Spread of Infection:

Sometimes, the bacteria that cause epiglottitis can spread to other parts of your body, causing other infections. These infections could include pneumonia (a lung infection), meningitis (an infection of the membranes surrounding the brain and spinal cord), or a bloodstream infection. It's important to get treatment for epiglottitis promptly to prevent these further complications.

The Hib vaccine protects children from epiglottitis, a serious throat infection caused by a bacteria called Haemophilus influenzae type b (Hib). In the US, most kids get the Hib vaccine in a series of shots: two doses at 2 months and 4 months old, and a third dose at 6 months for some children, and a final dose between 12 and 15 months of age.

Since older children and adults are less likely to get Hib infections, they typically don't need the vaccine. However, the Centers for Disease Control and Prevention (CDC) recommends it for older children and adults with weakened immune systems. These weakened immune systems can be due to several reasons, including:

• Blood disorders like sickle cell disease.
• HIV/AIDS.
• Having their spleen removed.
• Being treated with chemotherapy.
• Taking medicine to prevent organ or bone marrow transplant rejection.

While the Hib vaccine is generally safe, some people might experience side effects. These are usually mild and include:

• Redness, warmth, swelling, or soreness at the injection site.
• A low-grade fever.

Rarely, a more serious allergic reaction can occur. Symptoms of an allergic reaction can include:

• Difficulty breathing or wheezing.
• Hives (itchy welts on the skin).
• Weakness or dizziness.
• A fast heartbeat.

If you or your child experience any of these signs after a vaccination, seek immediate medical attention.

It's important to remember that even with the vaccine, some children who receive it can still get epiglottitis. Other germs can also cause the infection. To help prevent the spread of germs, good hygiene practices are important:

• Avoid sharing personal items.
• Wash your hands frequently with soap and water, or use an alcohol-based hand sanitizer when soap and water aren't available.

The Hib vaccine is a crucial tool in preventing epiglottitis, but it's not a guarantee. Following good hygiene practices can help protect everyone.

Doctors first make sure your airway is clear and you're getting enough oxygen. They closely watch your breathing and the level of oxygen in your blood.

If your oxygen levels get dangerously low, you might need help breathing.

To find the cause of your breathing problems, doctors might do these things:

• Throat exam: A thin, flexible tube with a light on the end (a fiber-optic scope) is used to look inside your throat through your nose. This lets doctors see what's happening. A little medicine to numb your nose can make this more comfortable. Sometimes, this exam happens in an operating room if your airway becomes blocked.

• X-ray of your chest or neck: X-rays aren't usually needed to diagnose the problem, but they can help doctors check for a condition called epiglottitis. In epiglottitis, an X-ray might show a rounded shadow in your neck, like a thumbprint. This is a sign that your epiglottis (a flap of tissue at the back of your throat) is swollen.

• Throat swab and blood tests: Once your breathing is stable, a doctor will carefully swab the back of your throat to collect a small sample of tissue. This sample is tested to see if there's a bacteria called Hib (Haemophilus influenzae type b). Doctors might also take blood samples to check for a blood infection called bacteremia. Bacteremia is often present when someone has epiglottitis.

Epiglottitis treatment starts by ensuring the person can breathe. This might involve several steps:

• Oxygen: A mask delivers extra oxygen directly to the lungs.

• Breathing tube (intubation): A tube may be inserted into the windpipe (trachea) through the nose or mouth. This tube stays in place until the swelling in the throat subsides, which can take several days.

• Needle cricothyroidotomy: In serious cases, a needle is inserted into the windpipe (trachea) to create a quick airway. This is a very rare procedure done to get air into the lungs immediately.

Once breathing is secure, treatment focuses on fighting the infection. This typically involves antibiotics:

• Broad-spectrum antibiotics: Because time is critical, doctors often start with a broad-spectrum antibiotic. A broad-spectrum antibiotic works against many types of bacteria. This means that treatment can begin quickly, before lab tests confirm which germ is causing the infection.

• Targeted antibiotics: The initial antibiotic might be changed later. This happens if lab tests identify the specific bacteria causing the epiglottitis. A more targeted antibiotic, designed to fight that particular bacteria, will be given to improve the chances of a faster recovery.