Epiglottitis

  • Basics

    Epiglottitis is inflammation of the epiglottis, the flap at the bottom of the throat that closes the entrance to the voice box and the windpipe Figure 01. The epiglottis normally remains in an open position to allow air to enter the windpipe. When you swallow, the epiglottis closes this entrance, preventing food or liquids from entering the airway. When infected with bacteria or a virus, the epiglottis may become sore, red, and swollen.

    Click to enlarge: The epiglottis (animation)

    Figure 01. The epiglottis (animation)

    Epiglottitis develops rapidly, and can be life threatening if not treated quickly. Epiglottitis develops rapidly, and is potentially more lethal than any other upper respiratory tract infection. When the epiglottis becomes inflamed and swollen, it obstructs the airway, and may close it off completely. Epiglottitis is an emergency situation because it can progress from a sore throat to complete airway obstruction in only a matter of hours. If you suspect that you or your child has epiglottitis, it is essential to get medical attention immediately.

    Epiglottitis is most common among young children, but it can affect people of all ages. Epiglottitis is most common among children between two and seven years of age, and occurs more frequently in boys than girls. However, epiglottitis can occur in children under the age of two, and in adults as well. The disease progresses more slowly in adults than in children, presumably because of the larger diameter of the adult airway.

  • Causes

    Epiglottitis is almost always caused by a bacterial infection. Epiglottitis is most often caused by an infection with Haemophilus influenzae type b.H. influenzaeis a common bacterium, and is also a leading cause of meningitis, pneumonia, ear infections, and sinus infections. Despite its name,H. influenzaedoes not cause the flu; it was mistakenly identified as a flu organism during the 1889 influenza pandemic.

    Epiglottitis caused byH. influenzae type b infection is less frequent now than in the past because the H. influenzae type b (HIB) vaccine is a routine part of early childhood immunization programs. As a result, epiglottitis most commonly occurs in children who have not received the vaccine.

    Infection with H. influenzae type b also causes pneumonia; in about 25% of cases, epiglottitis and pneumonia will occur at the same time. The infection may also spread to the joints, the linings of the brain, the tissue that surrounds the heart cavity, and the tissues under the skin. Infection of the blood (bacteremia) may also occur.

    In a small number of cases, viruses or bacteria other than H. influenzae type b can cause epiglottitis. In a small number of cases, epiglottitis may be caused by strains ofPneumococcus,Streptococcus,Staphylococcus, orKlebsiella bacteria. Therefore, it is possible that children who have received the HIB vaccine can still develop epiglottitis. Although such cases are also rare, viral epiglottitis can occur after infection with the herpes simplex virus.

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