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Epiglottitis

Definition

Epiglottitis is severe swelling of the epiglottis. The epiglottis is a flap-like tissue located in the throat. During swallowing, the epiglottis folds over the windpipe and vocal chords to prevent food and liquids from entering the lungs. Swelling can quickly seal off the airway and make breathing difficult.
Epiglottitis is rare and requires immediate medical attention. If you think you, your child, or someone you know has epiglottitis, go to the emergency room right away.
The Throat
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Causes

Factors that can cause epiglottitis include:

Risk Factors

Epiglottitis spreads easily. It is passed much like the common cold , through droplets released when sneezing and coughing. Anyone can develop epiglottitis.
This condition is more common in:
Other factors that may increase your risk include:

Symptoms

Symptoms may include
Symptoms appear suddenly and worsen quickly.
Note: Do not attempt to use a tongue depressor or any other utensil to look into the person’s throat. A throat spasm could occur and cause the airway to close completely.

Diagnosis

When you arrive at the hospital, the doctor will first make sure you are able to breathe. After this is known, you will be asked about your symptoms and medical history. If you are not having trouble breathing, a mirror may be used to look down your throat.
Your bodily fluids and cells may be tested. This can be done with:
Images may be taken of your bodily structures. This can be done with:

Treatment

The doctor will first stabilize your airway and then give proper medication depending on the cause. You may also have other illnesses that need to be treated depending on the cause of the epiglottitis such as blood infections.
If you CAN breathe, you will be closely monitored in the intensive care unit.
If you CANNOT breathe, the options include:
After the airway is stabilized, you will be monitored and started on IV antibiotics. Antibiotics help kill the organism causing the infection and swelling. At first, a variety of antibiotics may be given if the identity of the germ is not yet known. After the laboratory test results are known, a specific antibiotic can be given.
After swelling decreases, the breathing tube can be removed. Usually, there are not any lasting side effects of epiglottitis, and the outlook is good.

Prevention

Vaccination with the Hib vaccine is the only way to prevent epiglottitis. Currently, infants born in the US are given one of these vaccines at two months of age. Since vaccination began, adults have been at even lower risk of developing epiglottitis. If you have a weak immune system or are on medications that may make you more prone to illness, speak with your doctor about getting vaccinated.
An preventive antibiotic may be prescribed for:

RESOURCES

American College of Emergency Physicians http://www.acep.org

Centers for Disease Control and Prevention http://www.cdc.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Acute epiglottitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 21, 2013. Accessed September 24, 2014.

Haemophilus influenzae disease (including Hib). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hi-disease/index.html. Updated September 25, 2012. Accessed September 24, 2014.

Sack JL, Brock CD. Identifying acute epiglottitis in adults. Postgraduate Medicine. 2002;112(1).

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