A sore throat, hoarseness, and a high fever can develop rapidly in a child who had no previous symptoms Table 01[
Table 2]. The H. influenzae infection usually starts in the nose or throat and progresses down to the epiglottis. The back of the throat usually becomes inflamed, causing pain and hoarseness. It is common to experience a high fever, and to have difficulty swallowing and breathing. Children with epiglottitis may drool and wheeze while inhaling, and often lean forward, stretching the neck to make breathing easier. In many cases, the child will be severely short of breath by the time medical attention is sought.
The symptoms of epiglottitis in adults are often not as severe as those in children. While children usually experience severe difficulty breathing early in the course of epiglottitis (resulting in a stretched neck and forward-leaning posture), adults more often complain of severe pain in the throat and painful swallowing before developing respiratory symptoms. In addition, the course of the disease may extend over several days in adults, rather than the several hours common in children. As the disease progresses, many adults experience the same breathing difficulties, drooling, and wheezing common in children with the condition.
Table 1. Symptoms of Epiglottitis
Sore throat Hoarseness Fever Difficult or painful swallowing Labored breathing or shortness of breath Wheezing Drooling Forward-leaning posture Stretched neck
Children who have not received the HIB vaccine are at the greatest risk for epiglottitis. The HIB vaccine is highly effective, and is recommended for infants older than two months of age. A child who has not been vaccinated will also be at risk for other H. influenzae type b infections such as meningitis and pneumonia.
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