Acute epiglottitis is a rare, but potentially life-threatening bacterial infection of the epiglottis.
The epiglottis is a flap of cartilage that opens and closes the opening to the voice box (larynx) and windpipe (trachea).
Epiglottitis is most often caused by the bacteria Haemophilus influenzae type B (Hib).
This infection leads to rapid swelling of the epiglottis, which can fall backwards and block air from getting into the trachea and lungs. This leads to severe breathing difficulties or, in the worst case, stops breathing altogether (respiratory failure).
Epiglottitis can affect children and adults of any age and used to be most common in children between the ages of 2 and 6. Fortunately, epiglottitis is rare today because an effective vaccine against the Hib bacteria was introduced in 1985.
Epiglottitis usually starts with a fever and sore throat and then rapidly causes severe difficulty breathing.
The child may sit upright and lean forward in an attempt to get enough air in. They will have difficulty speaking and swallowing, and will often drool because they are not able to swallow their own saliva.
The child will often breathe with a harsh hissing or whistling sound (stridor), and may be very tied-looking (lethargic). The skin and tongue may look blue, which is a sign that there is not enough oxygen in the blood. This is a serious danger sign.
Epiglottitis is a life-threatening condition, because of the danger of complete blockage of the airways, and possible suffocation. Call a doctor or ambulance immediately by phoning 911.
If you suspect epiglottitis in your child, you must contact a doctor or ambulance by telephoning 911 immediately.
Try to comfort your child while speaking as calmly as possible.
Do not try to look into the child's mouth.
Do not lay the child down as this can worsen his condition and lead to choking. The child most likely will be sitting or lying in the position that gives him the best passage of air, so do not change the child's body position if possible.
The child must be transported to the hospital, where the doctors will first make sure the child is comfortable and getting enough oxygen. An X-ray of the neck may be ordered to look for signs of epiglottitis. The child will be given oxygen, if necessary, and intravenous antibiotics.
In some cases, the child may need the insertion of a breathing tube to insure adequate air supply; this tube is placed in the trachea past the swollen epiglottis. An Intensive Care Unit (ICU) is often needed for treatment and monitoring.
By vaccinating your child with the Hib vaccine, you will be protecting your child against the leading cause of epiglottitis.
The same bacteria can also cause meningitis in children, so it is an important vaccination. The Hib vaccine is included in the Recommended Childhood Immunization Schedule. Four doses are given at 2, 4, 6 and 12-15 months of age.
This vaccine has saved many children's lives in the US. Thankfully, acute epiglottitis is now quite rare among children who have received their Hib vaccines.
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