Darrick Robles Acute epiglottitis is a dreaded childhood disease that manifests itself with difficulty swallowing, slurred speech and high fever. With the introduction of vaccination around fifty years ago, the number of new infections has fallen sharply. At present, older and unvaccinated people are now more likely to contract the infection.
Definition of an epiglottis
Epiglottitis, also called supraglottic laryngitis, describes an acute inflammation of the epiglottis. The larynx is an anatomical structure between the pharynx and the trachea. It fulfills an important function in swallowing and speaking. Due to the inflammation, the larynx swells increasingly, which causes the patient the classic sore throat, swallowing and speaking difficulties. The great danger when the disease occurs is the swelling of the airways: the patient can suffocate.
Causes of Epiglottitis
An inflammation of the epiglottis can be triggered by various bacteria. Most often, Haemophilus influenzae type B (Hib) is responsible. In addition, the Hib triggers serious purulent meningitis.
Nowadays, some other pathogens can also be considered as triggers of the epiglottis, such as streptococci and pneumococci.
Symptoms of Epiglottitis
The disease is characterized by a very sudden onset with a high degree of illness. If you suspect an inflammation of the epiglottis, an ambulance with an emergency doctor should be called immediately, as there is a risk of death by suffocation.
- High fever
- Sore throat, difficulty swallowing
- Chunky language, altered voice
- High salivation
- Difficulty breathing up to shortness of breath, snoring noise when exhaling
In most cases, those affected do not have a cough or hoarseness. Patients tend to adopt a hunched-over, seated posture to breathe better.
Risk of infection of the epiglottis
The contagious bacteria are transmitted as droplet infection: tiny droplets can be spread through the air by sick people (e.g. through coughing and sneezing) and then inhaled by healthy people. Symptoms appear two to five days after infection. Since most people are vaccinated, there is usually no risk of infection for them.
Doctor’s consultation
An ambulance should be called immediately if you suspect that you have an inflammation of the larynx. The transport to the nearest clinic should be done with the doctor in a sitting position.
The condition is diagnosed based on its symptoms. Under certain circumstances, the doctor will inspect the throat and larynx, but this is only possible with prior intubation and is not recommended.
There are some other conditions that are similar to epiglottitis:
- Influenza infection (cold): Here, a sore throat, runny nose, cough and hoarseness occur as part of an infection of the upper respiratory tract. The onset of the cold is insidious and there are usually no breathing difficulties.
- Subglottic laryngitis (pseudocroup): Cough and hoarseness are the main symptoms of this disease caused by viruses. The children have no fever and are in good general condition. Pseudocroup occurs much more frequently than epiglottitis and heals without consequences.
- Laryngeal diphtheria (genuine croup): Here, too, the symptoms of coughing, hoarseness and shortness of breath are noticeable. In addition, there is often a sweetish bad breath and severely swollen lymph nodes. The rare disease is caused by bacteria against which a vaccine is available.
Swallowing a foreign body can also be reminiscent of an inflammation of the larynx. A doctor should be consulted immediately if there is any suspicion.
Therapy of epiglottitis
Therapy is primarily about keeping the airways open and securing them. This can be done with oxygen and intubation. In addition, some antibiotics offer effective therapy against the causative bacteria. These can be given via the vein in the inpatient setting in order to develop their full effectiveness.
If appropriate immediate measures are taken, the disease can be brought under control quickly and the duration is limited to a few days. Without immediate admission to a hospital and intensive monitoring, the epiglottis can be fatal.
Vaccination against hemophilus influenza
The standing vaccination committee recommends vaccination against hemophilus influenzae as part of the six-fold vaccination for children in their first year of life. The basic immunization should be started in the second month of life and consists of four vaccinations: it protects against the pathogens that cause laryngitis, whooping cough, polio, tetanus, diphtheria and hepatitis B. Two booster vaccinations should then take place in the fifth and fifteenth year of life.
It is very rare for patients to develop epiglottitis despite vaccination. These patients are referred to as vaccine failures.
How can Med-Healths help?
If you suspect epiglottitis, do not hesitate and call an ambulance immediately! You can consult a doctor via the Med-Healths app to ask questions about vaccination and give you tips on how to deal with childhood illnesses.
