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Epiglottitis

Intro

If epiglottitis is suspected, call for emergency medical services to take the person to a hospital's emergency department for further evaluation by a doctor.

The following combination of signs and symptoms should lead you to contact your doctor or go directly to a hospital's emergency department:

  • Sore throat
  • Muffled voice
  • fever
  • Inability to swallow
  • Fast heartbeat
  • Irritability

Respiratory distress characterized by drooling, Shortness of breath, rapid shallow breathing, very ill-looking appearance, upright posturing with tendency to lean forward, and stridor (high-pitched sound when breathing in)

Epiglottitis is a medical emergency. Someone who is suspected of having epiglottitis should be taken to the hospital. Any signs of difficulty in breathing should be reason enough to see a doctor.

If you experience a sudden onset of the following signs and symptoms, go directly to a hospital's emergency department:

  • Sore throat
  • Drooling
  • Inability to speak or swallow
  • Muffled voice
  • fever
  • Fast heart rate
  • Respiratory distress, such as stridor, short shallow breathing, fast breathing, or blue discoloration to the skin
Follow-up

Continue taking all antibiotics until the full course is completed. Keep all follow-up appointments with your doctor. In the event that a breathing tube had to be placed through the neck, follow-up with the surgeon to have the tube removed and make sure the site is healing well. Most people improve significantly before leaving the hospital, so taking the antibiotics and returning to the hospital if there are any problems are the most important parts of follow-up.

Prevention

Prevention of epiglottitis can be achieved with proper vaccination schedules against H influenza type b (Hib). Therefore it is important that your doctor make the appropriate recommendations for vaccination against Hib for children (see the children's immunization schedule). Adult vaccination is not routinely recommended, except for people with immune problems such as sickle cell anemia, splenectomy, cancers, or other diseases affecting the immune system .

When there is a member of a family with an unvaccinated child under age 4 years who is exposed to a person with H influenza epiglottitis, preventive medication (rifampin, Rifadin) should be given to all household contacts to make sure that both the person with the illness and the rest of the household have the bacteria completely eradicated from their bodies. This prevents formation of a "carrier state" in which a person has the bacteria in the body but is not actively sick. Carriers can still spread the infection to other family members in this state.

Outlook

A person with epiglottitis can recover very well with a good prognosis if the condition is caught early and treated in time. In fact, a good majority of people with epiglottitis do well and recover without problems. But if the person was not brought to the hospital early and was not appropriately diagnosed and treated, the prognosis may range from poor with prolonged physical handicap to death.

Before 1973, 32% of adults with epiglottitis died from the disease. With current vaccination programs along with earlier recognition and treatment, the overall death rate from epiglottitis is estimated to be less than 7%. The death rate from epiglottitis in adults is higher than that of children because the condition can be misdiagnosed. Other likely diseases look so much like epiglottitis.

Epiglottitis can also occur with other infections in adults, such as pneumonia . Most commonly, it is misdiagnosed as a strep throat. However, if it is suspected and treated appropriately, full recovery can be anticipated. Most of the deaths come from failure to diagnose it in a timely fashion and obstruction of the airway. As with any serious infection, bacteria may enter the blood, a condition called bacteremia, which may result in infections in other systems and sepsis (severe infection with shock, and often respiratory failure).

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