Epiglottitis Signs and Symptoms

• 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

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

• 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

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