Epiglottitis is a life-threatening condition that occurs when the epiglottis — a small cartilage "lid" that covers your windpipe — swells, blocking the flow of air into your lungs. A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to your throat, and various infections. The most common cause of epiglottitis is infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia and meningitis.

Alternative Names of Epiglottitis are: acute supraglottitis, thermal epiglottitis, and peritonsillar abscess.

Complications of Epiglottitis

• Epiglottitis can lead to respiratory failure - a life-threatening condition in which the level of oxygen in the blood drops dangerously low or the level of carbon dioxide becomes excessively high.
• Sometimes the bacteria that cause epiglottitis cause infections elsewhere in the body, such as pneumonia, meningitis or a blood infection (sepsis).
• Rarely, pulmonary edema, another life-threatening condition, can develop. It occurs when the tiny air sacs in the lungs fill with fluid, preventing them from absorbing oxygen.

Causes of Epiglottitis

Conditions that cause epiglottitis include infectious, chemical, and traumatic agents. Infectious is the most common. H influenzae type b was once the most common cause prior to vaccination. Currently, other organisms such as bacteria, viruses, and fungi are the causes, especially among adults.

• Various organisms that can cause epiglottitis include Streptococcus pneumoniae, Haemophilus parainfluenzae, varicella-zoster, herpes simplex virus type 1, and Staphylococcus aureus, among others.
• Other types of epiglottitis that are not caused by infection include hot things that may injure the epiglottis. Heat damage that results in epiglottitis is also known as thermal epiglottitis. Thermal epiglottitis occurs from drinking hot liquids, eating solid foods, or using illicit drugs such as inhalation of metal pieces from crack cocaine pipes or the tip of marijuana cigarettes. In these cases the epiglottitis from thermal injury is similar to the illness caused by infection.
• Unusual causes of epiglottitis include brown recluse spider bites to the ear, which may result in swelling or eating buffalo fish, which may cause an allergic like reaction and swelling. Blunt trauma or something blocking the throat may also lead to epiglottitis.

Signs & Symptoms of Epiglottitis

Epiglottitis caused by Hib infection usually begins with a fever and severe sore throat. Symptoms of epiglottitis may develop within a matter of hours, including:

• Fever
• Severe sore throat
• Difficult and painful swallowing
• Drooling due to severe pain when swallowing
• A muffled or hoarse voice
• Harsh, raspy breathing
• Difficulty breathing
• Blue skin or lips

Diagnosis of Epiglottitis

• If the medical team suspects that you have epiglottitis, the first priority is to ensure your airways are open and you're receiving enough oxygen.
• Once your condition is stable, the doctor may examine your throat using a flexible fiber-optic tube. A local anesthetic can help relieve any discomfort. Sometimes you may have a chest or neck X-ray as well. Because of the danger of sudden breathing problems, children may have X-rays taken at their bedside rather than in the radiology department — but only after the airway is protected.
• You're also likely to have a blood test and throat culture. For the culture, your epiglottis is wiped with a cotton swab and the tissue sample is checked for Hib. Blood cultures are usually taken because sepsis — a severe infection — often accompanies epiglottitis.

Treatments of Epiglottitis

• The first priority in treating epiglottitis is ensuring that you're receiving enough air. You may wear a mask that delivers oxygen to your lungs, but it's more likely that you'll have a breathing tube placed into your windpipe through your nose or mouth. The tube must remain in place until the swelling in your throat has decreased — sometimes for several days.
• In extreme cases or if more conservative measures fail, the doctor may need to create an emergency airway by inserting a needle directly into an area of cartilage in your trachea. This procedure, called a tracheotomy, allows air into your lungs while bypassing the larynx. The needle is removed as soon as the airway is open.
• If your epiglottitis is related to an infection, you'll receive intravenous antibiotics once you're breathing freely. Until your doctor knows the results of your blood and tissue cultures, you're likely to be treated with a broad-spectrum drug. You may receive a different antibiotic later, depending on what's causing your epiglottitis.

Prevention of Epiglottitis

Immunization with the Hib vaccine is an effective way to prevent epiglottitis in children younger than age 5. In the United States, children usually receive the vaccine in four doses:

• At ages 2 months
• At 4 months
• At 6 months
• At 12 to 15 months

The Hib vaccine is generally not given to children older than age 5 or to adults because they're less likely to develop Hib infection. But the Centers for Disease Control and Prevention recommend the vaccine for older children and adults whose immune systems have been weakened by:

• Sickle cell disease
• HIV/AIDS
• Spleen removal
• Chemotherapy
• Medications to prevent rejection of organ or bone marrow transplants

When to seek Medical Advice

Epiglottitis is a medical emergency. If you or someone you know suddenly has trouble breathing and swallowing, call your local emergency number or go to the nearest hospital emergency department. Try to keep the person quiet and upright. Don't try to examine the person's throat yourself. This can make matters worse.