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Epiglottitis

Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis — a small cartilage "lid" that covers your windpipe — swells, blocking the flow of air into your lungs.

A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to your throat and various infections. The most common cause of epiglottitis in children in the past was infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia, meningitis and infections in the bloodstream. Epiglottitis can occur at any age.

Routine Hib vaccination for infants has made epiglottitis rare, but epiglottitis remains a concern. If you suspect that you or someone in your family has epiglottitis, seek emergency help immediately. Prompt treatment can prevent life-threatening complications.

Symptoms Causes Risk factors Complications Prevention

Symptoms in children

In children, signs and symptoms of epiglottitis may develop within a matter of hours, including:

  • Fever
  • Severe sore throat
  • Abnormal, high-pitched sound when breathing in (stridor)
  • Difficult and painful swallowing
  • Drooling
  • Anxious, restless behavior
  • Greater comfort when sitting up or leaning forward

Symptoms in adults

For adults, signs and symptoms may develop more slowly, over days rather than hours. Signs and symptoms may include:

  • Severe sore throat
  • Fever
  • A muffled or hoarse voice
  • Abnormal, high-pitched sound when breathing in (stridor)
  • Difficulty breathing
  • Difficulty swallowing

When to see a doctor

Epiglottitis is a medical emergency. If you or someone you know suddenly has trouble breathing and swallowing, call your local emergency number or go to the nearest hospital emergency department. Try to keep the person quiet and upright, because this position may make it easier to breathe. Don't try to examine the person's throat yourself. This can make matters worse.

Epiglottitis is caused by an infection or an injury.

Infection

A common cause of swelling and inflammation of the epiglottis and surrounding tissues is infection with Haemophilus influenzae type b (Hib) bacteria. Hib is responsible for a number of serious conditions, the most common of which is meningitis.

Hib spreads through infected droplets coughed or sneezed into the air. It's possible to harbor Hib in your nose and throat without becoming sick — though you still have the potential to spread the bacteria to others.

Other bacteria and viruses also can cause inflammation of the epiglottis, including:

  • Streptococcus pneumoniae (pneumococcus), another bacterium that can cause meningitis, pneumonia, ear infections and blood infection (septicemia)
  • Streptococcus A, B and C, a group of bacteria that also can cause diseases ranging from strep throat to blood infections

Injury

Physical injury, such as a direct blow to the throat, can cause epiglottitis. So can burns from drinking very hot liquids.

You also may develop signs and symptoms similar to those of epiglottitis if you:

  • Swallow a chemical that burns your throat
  • Swallow a foreign object
  • Smoke drugs, such as crack cocaine

Certain factors increase the risk of developing epiglottitis, including:

  • Being male. Epiglottitis affects more males than females.
  • Having a weakened immune system. If your immune system has been weakened by illness or medication, you're more susceptible to the bacterial infections that may cause epiglottitis.
  • Lacking adequate vaccination. Delayed or skipped immunizations can leave a child vulnerable to Hib and increases the risk of epiglottitis.

Epiglottis can cause a number of complications, including:

  • Respiratory failure. The epiglottis is a small, movable "lid" just above the larynx that prevents food and drink from entering your windpipe. But if the epiglottis becomes swollen — either from infection or from injury — the airway narrows and may become completely blocked. This can lead to respiratory failure — a life-threatening condition in which the level of oxygen in the blood drops dangerously low or the level of carbon dioxide becomes excessively high.
  • Spreading infection. Sometimes the bacteria that cause epiglottitis cause infections elsewhere in the body, such as pneumonia, meningitis or a blood infection (sepsis).

Hib vaccine

Immunization with the Hib vaccine is an effective way to prevent epiglottitis caused by Hib. In the United States, children usually receive the vaccine in three or four doses:

  • At 2 months
  • At 4 months
  • At 6 months if your child is being given the four-dose vaccine
  • At 12 to 15 months

The Hib vaccine is generally not given to children older than age 5 or to adults because they're less likely to develop Hib infection. But the Centers for Disease Control and Prevention recommends the vaccine for older children and adults whose immune systems have been weakened by:

  • Sickle cell disease
  • HIV/AIDS
  • Spleen removal
  • Chemotherapy
  • Medications to prevent rejection of organ or bone marrow transplants

Vaccine side effects

  • Allergic reaction. Seek immediate medical help if you have an allergic reaction. Though rare, an allergic reaction may cause difficulty breathing, wheezing, hives, weakness, a rapid heartbeat or dizziness within minutes or a few hours after the shot.
  • Possible mild side effects. These include redness, warmth or swelling at the injection site, and a fever.

Common-sense precautions

Of course, the Hib vaccine doesn't offer guarantees. Immunized children have been known to develop epiglottitis — and other germs can cause epiglottitis, too. That's where common-sense precautions come in:

  • Don't share personal items.
  • Wash your hands frequently.
  • Use an alcohol-based hand sanitizer if soap and water aren't available.
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