Acute epiglottitis is a medical emergency since a problem with the epiglottis can interfere with breathing. Epiglottitis is inflammation of the epiglottis, which is a flap of cartilage that covers the windpipe while swallowing. It is located at the base of the tongue and prevents food from going into the trachea (windpipe). Infection of the epiglottis can potentially obstruct or completely close the windpipe.
There are few epiglottitis causes and limited to bacterial infection of the epiglottitis, mostly due to Haemophilus influenzae type B and in some cases due to Streptococcus pneumoniae or Streptococcus pyogenes. Epiglottitis is typically more common in children and normally attacks suddenly but may range from a few hours to few days. However, epiglottitis is becoming more common in adults in western countries, including USA and UK, mainly due to the introduction of Haemophilus influenzae vaccination.
Throat irritation is common to many diseases including laryngitis, pharyngitis, strep throat and tonsillitis. It is usually discarded as a minor irritant since it normally appears to be harmless. Throat irritation though does not figure among prominent epiglottitis symptoms, it can sometimes be a harbinger of epiglottitis.
Early epiglottitis symptoms are beguiling but can progress very fast and from throat irritation and swelling can rapidly result in bluish discoloration of the skin and mucous membranes and asphyxiation. In its initial stage, epiglottitis causes sore throat, muffling or changes in the voice, impaired speech, inability to swallow, abnormal heart beat, and respiratory distress. It is also marked by high fever but respiratory distress is by far the most prominent symptom. The patient appears in acute distress, anxious and leans forward, apparently struggling to breath and insists on sitting up in bed.
Diagnosis of epiglottis involves using a laryngoscope, a medical instrument for examining the larynx. The epiglottis and the two small cartilages at the back of the larynx to which the vocal folds are attached appear swollen and cherry-red in color. The doctor has to first rule out croup, abscesses in tonsils and in the tissues at the back of the throat.
Epiglottitis treatment involves antibiotic therapy but first attention is given to protect the airway for resumption of breathing. This requires endotracheal intubation, which is insertion of a cannula or tube into the trachea. It is a delicate procedure and should be performed by a certified professional specifically trained in anesthesiology. Infection is treated with third generation antibiotics such as Ceftriaxone or Chloramphenicol is used, either as a standalone epiglottitis treatment or in conjunction with penicillin or ampicillin.
Acute epiglottitis is a medical emergency requiring immediate medical attention but patients can recover and the disease has a good prognosis provided the condition is detected early and timely treatment is given.