Epiglottitis is a serious condition that causes inflammation and swelling of the epiglottis, the section of tissue at the top of the trachea. When a bacterial infection, virus, or throat injury damages the epiglottis, it becomes very difficult to breathe and swallow. Life-threatening respiratory failure can occur if epiglottitis is not diagnosed and treated in its earliest stages. Emergency breathing tubes, oxygen therapy, and anti-inflammatory medications are usually needed to prevent fatal complications.
Most cases of epiglottitis are triggered by a bacteria called Haemophilus influenzae, a widespread pathogen that usually does not cause problems in healthy people. Individuals with weakened immune systems, especially very young children, are at the highest risk of Haemophilus influenzae infection and subsequent epiglottitis. Many other pathogens can cause infection as well, including bacteria in the streptococci family and the herpes simplex virus. Less commonly, accidentally swallowing an irritant, smoking illicit drugs, or getting hit in the throat can cause serious irritation.
The epiglottis is made up of flexible cartilage tissue that folds up and down during respiration to allow air to pass through the trachea. When tissue becomes inflamed, the epiglottis swells and cannot fold properly. The initial symptoms of epiglottitis may include a mild fever, difficulty taking deep breaths, and a sore throat. As inflammation worsens, swallowing becomes painful and breathing gets very shallow. Respiratory failure is almost certain if the epiglottis becomes swollen enough to completely block the trachea.
A person who shows signs of epiglottitis needs to be brought to an emergency room as soon as possible. If airway restriction is severe, a doctor can insert a breathing tube to prevent respiratory failure. Oxygen may need to be administered if the trachea is partially opened but breathing is still shallow. Once the patient is stabilized, diagnostic imaging tests are performed to gauge the severity of damage to the epiglottis and surrounding tissue. Blood and throat tissue samples are collected and analyzed to determine the bacteria or virus responsible for symptoms.
After identifying the underlying cause and alleviating breathing difficulties, a doctor can administer intravenous antibiotics and anti-inflammatory medications. A patient is usually kept in the hospital for several days so doctors can carefully monitor his or her recovery. Once the patient starts feeling better, he or she is prescribed oral medications to take daily for one or two weeks and scheduled for a follow-up examination. With immediate treatment, most children and adults experience full recoveries from epiglottitis.