Epiglottitis
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Epiglottitis is a severe epiglottal inflammation and swelling caused by a bacterial infection.
Aetiology
Haemophilus influenzae.
Can be caused by a viral infection also such influenza virus or herpes simplex virus.
Trauma to the neck.
Pathophysiology
The bacteria or virus infiltrates the airways > inflammatory response > swelling and redness.
Obstruction of airways > SOB, wheeze and stridor.
Increased risk of infection > impaired swallowing.
Risk factors
Children are more at risk age 2 - 6.
Weak immune system.
Previous infections can increase risk of epiglottitis.
Smoking.
Trauma to throat/neck.
Unvaccinated.
Chronic lung conditions such as asthma / COPD.
Sign and symptoms
Inspiratory stridor
Restlessness, cough, SOB, fever and drooling.
Remember the 4 D’s: dysphagia, drooling, odynophagia and respiratory distress.
O/E: fever, tachycardia, tachypnoea, cyanosis.
Diagnosis and investigations
Refer urgently to ENT.
Laryngoscopy: cherry red epiglottis.
Neck x-ray: thumbprint Sign.
CT scan: may show obstruction.
Management
Airway management is generally done by ENT / anaesthetic + oxygen therapy.
IV antibiotics (ceftriaxone) + steroids to reduce swelling.
Immunisation to prevent.
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