Epiglottitis
What is epiglottitis?
Epiglottitis is a condition that requires emergency medical attention. It can lead to death if not treated immediately. The epiglottis is a tissue with the function of a valve at the base of the tongue, which prevents food from entering the trachea /breathing tube/ when swallowing.
When this tissue becomes inflamed or infected, it can swell and obstruct the movement of air through the trachea or completely block it. This condition can be fatal unless treated promptly.
Infection of the respiratory tract, exposure to certain substances or trauma, can lead to inflammation and infection of the adjacent organs around the larynx and include the epiglottis.
The disease begins as inflammation and swelling in the area between the base of the tongue and the epiglottis. Prolonged inflammation and swelling of this tissue can result in complete obstruction of the airway, leading to suffocation and death.
What are the symptoms of epiglottitis?
When the disease appears, it usually progresses very quickly – from a few hours to a few days after the initial symptoms appear. The most common symptoms are: sore throat, hoarseness or changes in voice, difficulty speaking, fever, difficulty swallowing. The affected person looks very ill.
Other characteristic symptoms are:
- Difficult breathing – respiratory distress;
- Slobbering from the affected person’s mouth;
- Leaning forward to breathe;
- Superficial and rapid breathing;
- Tightness in the muscles of the neck and between the ribs when breathing;
- Shrill whistling sound when breathing /stridor/;
What are the causes?
The causes of the clinical condition can be -infections, the body’s reaction to certain substances and trauma. Infections are the most common cause. Haemophilus influenza type B was the most common cause before mass vaccinations began. Currently, other organisms such as bacteria, viruses and fungi are the main causes, especially in adults.
Microorganisms that can cause the disease are – Streptococcuspneumoniae, Haemophilusparainfluenzae, varicella zoster virus, herpes simplex virus type 1 /oral herpes/, Staphylococcusaureus and others.
The disease can also be caused by excessive exposure to heat. It can occur from drinking hot liquids and eating very solid foods. In very rare cases, swelling of the epiglottis can be caused by allergic reactions to foods, insect stings or bites, or due to blunt force trauma to the neck or throat.
Treatment of epiglottitis
If epiglottitis is suspected, immediate hospitalization is required, as the affected person’s airway may close suddenly. When the affected person arrives at a hospital, the doctor, after a careful physical examination, must make a diagnosis. An x-ray of the respiratory tract is taken and a tube is placed in the trachea of the affected person, which ensures normal breathing.
The patient is left under observation in a dimly lit room. If there are no signs of airway obstruction, intravenous fluids will be helpful. It is important to prevent anxiety, as this can lead to acute airway obstruction, especially in children. In extremely rare cases, a tracheostomy may be necessary – a surgical intervention in which a special tube is inserted into the trachea through an incision in the skin of the neck.
Prevention
Prevention of epiglottitis is achieved with the introduced mandatory vaccination against Haemophilus influenza type B. Vaccination for adults who are not immunized is not recommended except for people with immune diseases such as sickle-cell anemia, splenectomy , cancer or other diseases that affect the immune system.
