Epiglottitis
Definition:
Epiglottitis is the inflammation of the
epiglottis - the flap that sits at the base of the tongue, which keeps food
from going into the trachea. Due to its place in the airway, swelling of this
structure can interfere with breathing and constitutes a medical
emergency. The infection can cause the
epiglottis to either obstruct or completely close off the windpipe
Cause:
Epiglottis
involves bacterial infection of the epiglottis, most often caused by
Haemophilus influenza type B.
Symptoms:
-fever
-difficulty
in swallowing
-drooling
-hoarseness
of voice
-stridor
Diagnosis:
Diagnosis is confirmed by direct inspection
using laryngoscopy, although this may provoke airway spasm.
If it is suspected,
attempts to visualize the epiglottis using a tongue depressor are strongly
discouraged for this reason. A paediatric, anaesthesia or ENT specialist should
be alerted immediately. Imaging is rarely useful, and treatment should not be
delayed this test to be carried out.
Management
:
Epiglottis
requires urgent tracheal intubation to protect the airway. Given in the initial
stages to reduce symptoms, but this will not treat the underlying cause. It
should also be noted that if stridor becomes quieter, obstruction is likely to
follow, and thus intubation should be expedited even further.
In addition, patients should be given
antibiotic such as second or third generation cephalosporins.
Complications:
-
pneumonia
-lymphadenopathy
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