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  3. Epiglottitis: Symptoms, Causes, Treatment

Epiglottitis

Epiglottitis is a life-threatening condition that causes swelling of the epiglottis, a flap of tissue that covers the trachea (windpipe) during swallowing to prevent food from entering the airway. Symptoms include a high fever, difficulty breathing, drooling, and a sore throat. The condition is most commonly caused by a bacterial infection, but can also be caused by a virus or a fungus. It is more common in children than in adults. Epiglottitis requires urgent medical attention, as it can rapidly progress to complete airway obstruction, which can lead to respiratory failure and death. Treatment involves hospitalization, including the use of antibiotics, oxygen therapy, and possibly intubation or tracheostomy to secure the airway. Vaccination against the bacterial cause of epiglottitis is available and recommended, especially for children.

Symptoms of Epiglottitis

What are the common symptoms of Epiglottitis?

The common symptoms of Epiglottitis include high fever, difficulty swallowing, drooling, rapid breathing, stridor, which is a high-pitched sound when breathing, and leaning forwards while sitting or standing to breathe more comfortably.

What is the main cause of Epiglottitis?

The main cause of Epiglottitis is a bacterial infection, most commonly caused by the bacteria Haemophilus influenzae type b (Hib). Other bacterial and viral infections can also lead to the development of Epiglottitis.

Does inflammation of the epiglottis always cause difficulty in breathing?

Inflammation of the epiglottis doesn`t always cause difficulty in breathing. However, it may cause difficulty swallowing, increased heart rate, and fever.

How does a bacterial or viral infection lead to the development of Epiglottitis?

Bacterial or viral infections can lead to the development of Epiglottitis by causing inflammation of the epiglottis, which is a piece of cartilage that covers the entrance to the trachea during swallowing to prevent food from entering the lungs. The inflammation of the epiglottis can narrow the airway, leading to difficulty in breathing.

Can Epiglottitis cause fever and chills as symptoms?

Yes, Epiglottitis can cause fever and chills as symptoms.

Diagnosis of Epiglottitis

What tests are commonly used for diagnosing epiglottitis?

Diagnosis of epiglottitis typically involves a combination of clinical presentation, physical examination, throat culture, and imaging tests. Blood tests may also be performed to evaluate the severity of the infection. In terms of imaging tests, a lateral neck soft tissue x-ray is commonly performed to evaluate the size and shape of the epiglottis. However, this test has limitations and may not always provide a clear diagnosis. CT scans and MRI are also highly sensitive and specific tests, but they are typically reserved for cases where there is a high level of suspicion for a malignant process or an abscess. Throat cultures can be helpful in detecting the causative organism, which can help guide antibiotic therapy. 2. A physical exam alone is not enough to accurately diagnose epiglottitis. While certain physical findings, such as drooling or stridor, are highly suggestive of the condition, other underlying causes may present with similar symptoms. A thorough evaluation that includes imaging and laboratory tests is necessary to make an accurate diagnosis. 3. Imaging tests, such as x-ray, CT, or MRI, can be helpful in confirming the presence of epiglottitis and evaluating the extent of the inflammation. However, these tests are not always necessary for diagnosis and may be reserved for cases where there is a high suspicion of a complication, such as abscess formation. 4. Throat cultures can help diagnose epiglottitis by detecting the causative organism. This information is essential for guiding antibiotic therapy and preventing recurrent infections. A culture may be obtained by swabbing the throat, and the sample is then sent to a laboratory for analysis. 5. Blood tests are not typically used to diagnose epiglottitis, but they may be used to assess the severity of the infection. An elevated white blood cell count may suggest an active infection, while other markers can be used to evaluate the patient`s overall health and response to treatment. However, blood tests alone are not enough to make a definitive diagnosis of epiglottitis.

Can a physical exam alone accurately diagnose epiglottitis?

Source: UpToDate. (2021, January 29). Diagnosis and management of acute epiglottitis in adults. Retrieved from https://www.uptodate.com/contents/diagnosis-and-management-of-acute-epiglottitis-in-adults.

Is it necessary to use imaging tests in the diagnosis of epiglottitis?

How does a throat culture help diagnose epiglottitis?

What is the role of blood tests in the diagnosis of epiglottitis?

Treatments of Epiglottitis

What are the initial steps in managing epiglottitis?

The initial steps in managing epiglottitis include stabilizing the patient`s airway and administering supplemental oxygen if necessary. A pediatric anesthesiologist or otolaryngologist should be involved in the evaluation of the patient to help determine the optimal method for securing the airway. A lateral neck radiograph or CT scan should be obtained to confirm the diagnosis, and blood cultures should be taken to assist with antibiotic selection. In certain cases, patients may require an emergency tracheostomy or endotracheal intubation to secure their airway.

Which medications are commonly used in the treatment of epiglottitis?

Source: UpToDate

What is the role of intubation in the management of epiglottitis?

Antibiotics are the cornerstone of treatment for epiglottitis. Commonly used antibiotics include third-generation cephalosporins such as ceftriaxone, macrolides such as azithromycin, and penicillins such as amoxicillin-clavulanate. Intravenous (IV) antibiotics are typically used initially, with oral antibiotics used for completion of therapy.

How is antibiotic therapy typically administered in the treatment of epiglottitis?

Source: UpToDate

What is the recommended follow-up protocol for patients with epiglottitis after treatment?

Intubation is a critical component of the management of epiglottitis in patients who are unable to maintain their own airway or have evidence of impending respiratory failure. However, due to the risk of inducing complete airway obstruction during intubation, it is important that a skilled anesthesiologist, otolaryngologist, or pediatric intensivist is involved in the process of securing the airway. In some cases, a tracheostomy may also be necessary to provide long-term airway management.

Prognosis of Epiglottitis

What is the usual outcome of Epiglottitis?

Epiglottitis is a serious condition where the epiglottis, a flap of tissue that closes the trachea during swallowing, becomes swollen and inflamed, leading to difficulties breathing and swallowing. If left untreated, it can lead to asphyxiation, which can be fatal. 2. With prompt medical intervention, the chances of recovery from Epiglottitis is good. However, since it is a medical emergency, early medical attention must be sought immediately if symptoms occur. 3. Epiglottitis is considered a serious condition as it can cause rapid breathing difficulties and can be fatal if left untreated. It is a medical emergency that requires urgent hospital admission and treatment. 4. The recovery time from Epiglottitis varies depending on how severe the condition is and how quickly treatment is received. With proper medical attention, most people can recover in a matter of days. 5. Epiglottitis can cause long-term damage or disability if not treated promptly. If the condition is not properly treated, it can lead to permanent breathing difficulties, permanent scarring of the airway, and even death. Therefore, it is important to seek medical attention immediately if symptoms occur.

What are the chances of recovery from Epiglottitis?

Sources:

Is Epiglottitis considered a serious condition?

- Mayo Clinic. "Epiglottitis." www.mayoclinic.org/diseases-conditions/epiglottitis/symptoms-causes/syc-20372236. - National Health Service. "Epiglottitis." www.nhs.uk/conditions/epiglottitis/.

How long does it take to recover from Epiglottitis?

Can Epiglottitis cause long-term damage or disability?

Prevention of Epiglottitis

What are some ways to prevent the development of Epiglottitis?

Ways to prevent the development of Epiglottitis include getting the Hib vaccine to prevent Haemophilus influenzae type B infection, which is one of the common causes of Epiglottitis, avoiding exposure to people who have respiratory infections, maintaining good hygiene practices, and avoiding smoking or exposure to second-hand smoke.

How can we reduce the risk of getting Epiglottitis?

The risk of getting Epiglottitis can be reduced by taking preventative measures such as practicing good hygiene, avoiding close contact with people who have respiratory infections, getting vaccinated against Haemophilus influenzae type B, and avoiding smoking or exposure to second-hand smoke.

What measures can be taken to avoid contracting Epiglottitis?

To avoid contracting Epiglottitis, individuals should practice good hygiene, such as washing hands regularly, avoiding close contact with people who have respiratory infections, getting vaccinated against Haemophilus influenzae type B, and avoiding smoking or exposure to second-hand smoke.

Are there any preventative measures that can be taken against Epiglottitis?

Preventative measures against Epiglottitis include getting vaccinated against Haemophilus influenzae type B if required, practicing good hygiene by washing hands regularly, avoiding close contact with people who have respiratory infections, and avoiding smoking or exposure to second-hand smoke.

What are the most effective methods for preventing Epiglottitis?

The most effective methods for preventing Epiglottitis include getting vaccinated against Haemophilus influenzae type B, maintaining good hygiene practices, avoiding close contact with people who have respiratory infections, and avoiding smoking or exposure to second-hand smoke. These measures will help reduce the risk of developing Epiglottitis and prevent its spread to others. Source: Centers for Disease Control and Prevention (CDC).