Inflammation of the epiglottis, a flap of cartilage that closes over the main airway to the lungs when food is swallowed
- Most common between the ages of 1 and 6
- Gender, genetics, and lifestyle are not significant factors
In this rare condition, the epiglottis, a flap of tissue behind the tongue that prevents food from entering the airways of the lungs during swallowing, becomes inflamed due to infection. Inflammation causes the epiglottis to swell so that the main airway is partially blocked. The swelling can be so severe that the child is unable to breathe. This situation is life-threatening and needs urgent hospital treatment.
Epiglottitis is caused by infection with the bacterium Haemophilus influenzae type B (Hib). Children between 1 and 6 years old are most commonly affected. Epiglottitis is now rare in the UK due to routine immunization of babies.
What are the symptoms?
In most cases, the symptoms of epiglottitis develop suddenly over a period of 1–2 hours and may include:
Severe sore throat.
Saliva dribbling from the mouth.
Restlessness and anxiety.
Rapid, laboured breathing.
Harsh noise on inhaling.
If there is severe obstruction of the airway, your child may become short of oxygen, possibly causing his or her lips, tongue, and skin to become blue-tinged. If your child develops difficulty swallowing or breathing, you should call for an ambulance immediately.
What might be done?
Initially, your most important tasks are to get immediate medical help then to reassure your child and try to keep him or her calm. You should not attempt to examine your child’s throat because this may increase distress, resulting in further blockage of the airway. Your child will probably be more comfortable sitting upright with his or her chin jutting out to maintain an unobstructed flow of air into the lungs.
The doctor will probably make a diagnosis from your child’s symptoms. Humidified oxygen will need to be given through a mask held near to his or her face. In hospital, your child will probably be taken to the operating theatre and given an inhaled anaesthetic so that a tube can be inserted into the main airway to keep it open. To maintain breathing, your child may need mechanical ventilation. To treat the Hib infection, your child will be given intravenous antibiotics.
What is the prognosis?
Most children recover in about a week. The tube that keeps the airway open is usually removed after about 2–3 days. There are usually no long-term problems, and the condition does not recur.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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