What is Epiglottitis ? Causes, diagnosis and treatment of epiglottitis

What is Epiglottis?

• Epiglottis is a leaf shaped soft bone (cartilage) at the base of the tongue.
• It is a flap like structure, which block the entry of food materials from entering the windpipe.
• Epiglottis open during movement of air in and out of respiratory organ and give way for air to enter the airway.
• It rolls backward while swallowing and prevent foreign particles that enter the airway and breathing organ [lung].

What is Epiglottitis?

Epiglottitis is the swelling (inflammation) of the epiglottis.

Enlargement of epiglottis may lead to blockage of upper airway by blocking the entry of air during respiration.
It usually causes breathlessness and blockage of windpipe. It is a medical emergency and may lead to death if proper treatment is not initiated immediately.

What are the causes of epiglottitis?

• Direct or indirect injury to epiglottis
• Intake of hot substance
• Inhalation of smoke, acid fumes and other irritants.
• Bacterial infection: Hib [haemophilus influenzae], Streptococcus pneumonia
• Fungal Infection: Candida,
• Viral Infection: Herpes simplex.

Who are infected often?

Epiglottitis usually affects children, but it can occur at any age. Epiglottitis affects non immunized and malnourished people.

What are the signs and symptoms of Epiglottitis?

• Fever (increase in body temperature)
• Hoarseness of voice
• Cough
• Painful swallowing
• Throat pain can occur with or without swallowing
• Stridor [musical breathing]
• Speaking difficulty
• Cyanosis (bluish coloration of face lips etc.)

What are the Four D s in epiglottitis?

Dyspnoea: difficulty in breathing,

Dysphagia: difficulty in swallowing,

Dysphonia: difficulty in speaking (voice disorder),

Drooling: dribbling of saliva.

How to diagnose epiglottitis?

• Chest X-ray and lateral view of neck.
• Thumb sign- enlarged epiglottis will look like thumb in lateral view of neck.
• Throat swab for gram stain, culture and drug sensitivity testing.
• Routine Blood tests
• Laryngoscopy.

Treatment for epiglottitis

• Administration of oxygen (to maintain oxygenation)
• Endo tracheal intubation (to maintain an airway with artificial breathing support system)
• Antibiotics (stops the growth of bacteria and kills the cause of infectious organisms)
• IV fluids
• Position the patient [sit up-right position]
• Cool mist humidification

How can we prevent Epiglottitis?

• Avoid drinking very hot drinks.
• Avoid inhaling toxic fumes.
• Wash hands often and avoid placing fingers in to mouth and nose.
• Increase natural immunity with nutritious food.
• Vaccination: By taking Hi b ( Haemophilus influenzae –type B) Vaccinatin.