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Epiglottitis

Definition


Disease: Epiglottitis Epiglottitis
Category: Ear, nose, larynx diseases

Disease Definition:

The epiglottis is a small cartilage or lid that covers the windpipe. When the epiglottis swells and blocks the flow of air into the lungs, epiglottitis occurs, which is a life-threatening condition.

 

Direct injury to the throat, burns from hot liquids and various infections are some of the factors that could cause the epiglottis to swell. However, its most common cause is infection with Haemophilus influenza type b (Hib). This bacterium also causes meningitis and pneumonia.

 

Although this disease remains a concern, however it is rare due to routine Hib vaccination. One should seek immediate emergency care when suspecting that he/she or someone in the family has epiglottitis. Life-threatening complications could be prevented with prompt treatment.
 

Work Group:


Symptoms, Causes

Symptoms:

Fever and severe sore throat are the first symptoms of epiglottitis caused by Hib infection. Within a few hours, the patient may develop some of these signs and symptoms:

 

  • Fever
  • Severe sore throat
  • Blue skin or lips
  • Harsh, raspy breathing
  • Difficulty breathing
  • A muffled or hoarse voice
  • Difficult and painful swallowing
  • Drooling due to severe pain when swallowing.
     

Causes:

The larynx, also called the voice box, consists of cartilage, muscle and mucous membrane that forms the entrance to the trachea, also known as the windpipe, namely, the tube that connects the mouth and throat to the lungs. Just above the larynx there's the epiglottis, a small movable “lid” that prevents food and drink from entering the windpipe.

 

The epiglottis does its job by dropping down when someone swallows, and effectively sealing off the larynx, which is why someone can’t swallow and breathe at the same time. The epiglottis is slightly lifted when a person is not eating or drinking in order to let air flow freely into the lungs. However, this airway could get narrowed or even completely blocked in case the epiglottis becomes swollen either from injury or from an infection.

 

INFECTION:

Infection with Haemophilus influenza type b (Hib) bacteria is the most common cause of swelling and inflammation of the epiglottis and surrounding tissues. Hib is responsible for some serious conditions, such as meningitis and respiratory tract infections, however, it doesn’t cause the flu. Hib spreads through infected droplets coughed or sneezed into the air. It is quite possible to harbor Hib in the nose and throat without becoming sick, however, that person will still have the potential to spread the bacteria to others.

 

Some of the other bacteria and viruses that can cause inflammation of the epiglottis include:

 

Varicella zoster:

This virus causes shingles and chickenpox.

 

Streptococcus A, B and C:

These are a group of bacteria that could cause diseases ranging from strep throat to blood infections.

 

Candida albicans:

This fungus is responsible for oral thrush, diaper rash and vaginal yeast infections.

 

Streptococcus pneumonia (pneumococcus):

This bacterium could cause ear infections, pneumonia, meningitis and sepsis, which is a blood infection.

 

INJURY:

A direct blow to the throat or other physical injuries could cause epiglottitis. This condition could also be caused by drinking very hot liquids or scald burns to the face.

 

A person may develop some signs and symptoms that are similar to those of epiglottitis in case they:

 

  • Swallow a foreign object
  • Smoke drugs, including heroin and crack cocaine
  • Swallow a chemical that burns their throat.
     

Complications

Complications:

In some cases, epiglottitis could lead to respiratory failure, which is a life-threatening condition where the level of carbon dioxide becomes excessively high or the level of oxygen in the blood drops dangerously low.

 

In some cases, the same bacteria that cause epiglottitis could cause infections elsewhere in the body, including meningitis, pneumonia or sepsis, which is a blood infection.

 

In some rare cases, another life-threatening condition could develop, known as pulmonary edema. When the tiny air sacs in the lungs fill with fluid, preventing them from absorbing oxygen, pulmonary edema occurs.
 

Treatments:

Ensuring that the patient is receiving enough air is the first thing done in treating epiglottitis. Most likely, the patient will have a breathing tube placed into their windpipe through the nose or mouth, which must remain in place until the swelling in the throat has decreased, it could last several days; or the patient could wear a mask that delivers oxygen to his/her lungs.

 

If conservative measures fail, in some extreme cases, an emergency airway may need to be created by inserting a needle directly into an area of cartilage in the patient's trachea. This allows air into the lungs, while bypassing the larynx, and as soon as the airway is open, the needle is removed. This procedure is called a tracheotomy.

 

The patient may receive intravenous antibiotics once they're breathing freely, in case the epiglottitis is related to an infection. The patient is most likely to be treated with a broad-spectrum drug until the doctor knows the results of the blood and tissue cultures. Depending on what’s causing the epiglottitis, the patient may receive a different antibiotic later.
 

Prognosis:

Not available

Expert's opinion

Expert's Name:
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Expert's opinion:

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Clinical Trials:

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Consultants Corner

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Dr . Dirar Abboud

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Dr. Hani Najjar

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Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician
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