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Pediatric and Adult Epiglottitis
This is a potentially life-threatening bacterial upper respiratory infection most commonly found in children ages 2-7 years. There are some sporadic cases in which adults also have contracted this bacterial disease. The infection involves the EPIGLOTTIS, a fleshy, cartilaginous structure that serves as a protective "flap" over the entrance to the lungs. Swelling of this structure from a bacterial infection results in a potentially occluded airway and death. Common symptoms include: abrupt onset of illness with high fevers, difficulty swallowing, drooling, and noisy breathing sounds (when BREATHING IN) known as "stridor". Stridor is also seen in a much less serious illness called croup. Children with epiglottitis tend to lean forward (making breathing easier for them), and are unable to lie flat as they struggle to draw in their breath.
A whispery, DIMINISHED voice is common. Adults appear "less ill" than children with this disease, but they will complain of difficulty swallowing, diminished voice, accompanied by fever and SEVERE sore throat. Evaluation by the physician will include history and physical exam. X-rays of the neck will be done immediately with close supervision, for any increasing airway blockage. Central to making this diagnosis in adults, is to suspect it in any case that involves "severe" sore throat, difficulty swallowing, while the throat appears normal during direct examination (with a tongue blade). If epiglottitis is suspected, the child must be kept calm. There will be no blood draws to otherwise excite the child, and the mother should remain holding the child at all times. Airway management is accomplished in a controlled setting (operating room) by an Anesthesiologist trained to handle this emergency. An ENT specialist will be close by, should any advanced airway support be needed. Hospitalization is necessary and IV antibiotics are required.
Hope this article will provide you information about pediatric and adult epiglottitis.
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