Epiglottitis is inflammation of the epiglottis. Due to its place in the airway, swelling of this structure can interfere with breathing and constitutes a medical emergency.

Cause

It involves bacterial infection of the epiglottis, most often caused by Haemophilus influenzae type B, although some cases are attributable to Streptococcus pneumoniae or Streptococcus pyogenes.

Symptoms

Epiglottitis typically affects children, and is associated with fever, difficulty swallowing, drooling and stridor. The early symptoms are insidious but rapidly progressive, and swelling of the throat may lead to cyanosis and asphyxiation.

Diagnosis

Diagnosis is confirmed by direct inspection using laryngoscopy. The epiglottis and arytenoids are cherry-red and swollen.

Treatment

Epiglottitis requires urgent endotracheal intubation to protect the airway. Ideally, this should be performed by an experienced anesthesiologist, with otolaryngology back-up in case of failed intubation. If intubation fails, tracheostomy is required.

In addition, patients should be given an antibiotic drug such as ceftriaxone.

Complications

Some patients may develop pneumonia, lymphadenopathy or septic arthritis.