epiglottitis
EPIGLOTTITIS
Epiglottitis is the inflammation of the epiglottis and supraglottic tissues (aryepilottic folds, arytenoid, uvula).
It is often characterized by an acute, rapidly progressing respiratory disease.
It is a medical emergency in children requiring immediate treatment and typically artificial airway placement.
H. influenzae type B is the most common etiologic agent in children.

Introduction

  • Also known as supraglottitis or cherry-red epiglottitis
  • Characterized by an acute, rapidly progressing respiratory disease 
  • A medical emergency requiring immediate treatment & typically artificial airway placement

Epidemiology

  • Usually affects children between 1-5 years old who have not been immunized or are under-immunized for Haemophilus influenzae
  • May occur in an adult w/ a sore throat in areas where H influenzae infections have largely been prevented by immunization
  • Epiglottitis patients often have an underlying disease, usually viral
  • Usually, there are no other family members suffering from acute respiratory symptoms

Definition

  • Inflammation of the epiglottis & supraglottic tissues (aryepiglottic folds, arytenoid, uvula)

Etiology

  • H influenzae type b (HIB) is the most common etiologic agent in children
    • The incidence of epiglottitis has decreased because of widespread vaccination against HIB
    • Second most common cause is group A beta hemolytic Streptococcus
    • Other causative organisms now include Streptococcus pyogenes, S pneumoniae & Staphylococcus aureus

Signs and Symptoms

Children

  • High fever & severe sore throat which is often of sudden onset
    • Barking cough is uncommon
  • Dyspnea, w/ possible rapid progression to airway obstruction
  • Difficulty in swallowing
  • Drooling due to inability to handle secretions, w/ hyperextension of the neck
    • Drooling w/o coughing increases the probability of epiglottitis compared to croup
  • Patient may prefer to sit upright while leaning forward w/ chin up & mouth open while bracing on the arms
  • Inspiratory stridor may be severe & may herald complete airway obstruction
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