Epiglottitis

Introduction
Epiglottitis is a life-threatening condition defined by inflamed epiglottis tissue.

An epiglottis is cartilaginous and is located at the base of tongue. It obstructs food from entering the windpipe. The tissue of the epiglottis can swell and block one’s airway. It is always advisable to get prompt medical treatment.

Though epiglottitis is uncommon, it usually affects children. Hib Vaccines (Haemophilus influenzae type b) offer protection to children from contracting the bacteria causing epiglotitis.

Causes
A bacterial infection is the most common cause of epiglottitis. Bacteria can enter your body through inhalation and infect your epiglottis. The most common strand of bacteria that causes this condition is Haemophilus influenzae type b, also known as Hib. It mostly affects males.

One can contract Hib by inhaling the germs spread by already infected people.

Other bacteria strands that can cause epiglottitis include Streptococcus A, B, or C and Streptococcus pneumoniae. These same bacteria also cause strep throat. Also, viruses responsible for shingles and chickenpox can also cause epiglottitis. Fungi from diaper rash or yeast infections can also contribute to inflammation of the epiglottis. A weak immune system is more susceptible to catch this infection.

Other causes for this condition include:

  • throat injury
  • drinking hot beverages
  • cocaine addiction

Symptoms
The symptoms of epiglottitis vary between children and adults. Children can develop epiglottitis within a matter of hours. In adults it develops more slowly, usually over the course of days.

Symptoms in children include upper respiratory infection; fever with chills; sore throat with hoarse voice; and restlessness.

Adults find difficulty in breathing accompanied by noisy breathing due to choking of airway, and change in voice. Sore throat is a common symptom.

The patient may show bluish discoloration of skin due to lack of oxygen.

If left untreated, epiglottis can block the airway completely.

Diagnosis
Following tests may be conducted to confirm the diagnosis:

  • throat examination using a fiber optic tube
  • X-rays of the throat and chest to check severity of inflammation and infection
  • throat and blood cultures to know the cause of infection

Treatment
When the physician suspects epiglottitis, treatment typically involves monitoring oxygen levels with an oximeter. When blood-oxygen levels become too low, the physician may offer following treatments:

  • intravenous fluids for nutrition and hydration till patient is able to swallow again
  • antibiotics to cure bacterial infection
  • anti-inflammatory medication to decrease swelling in the throat
  • a minor surgical procedure calling for a needle insertion into the trachea tissue, also known as a tracheotomy to allow exchange of oxygen and prevent respiratory failure

Epiglottitis can be prevented by administering Hib vaccine to children at 2 months of age. Maintaining hand hygiene and following a healthy diet.

If one lives in close proximity to epiglotitis patient, it is wise to get tested for Hib.

Homeopathic Remedies
Belladonna is suggested when there is redness of the throat or swollen tonsils without pus and when throat pain worsens from swallowing liquids.

Phytolacca cures sore throat with body aches and fever or when the throat appears dark red or even purplish or bluish. Pain is experienced in ears at the time of swallowing drink.

Mercurius is prescribed in case of pus in the throat accompanied by pain, swollen tongue and bad breath.

Lycopodium is given for sore throat that worsens on the right side. Pain relieved by warm drinks and warm food/

Lachesis is given when pain worsens from drinking liquids. Sore throat worsens in morning, especially on waking.

Hepar sulph is given when pus forms and also swelling is observed in throat and tonsils.

Arsenicum is beneficial for Chilliness, thirst, and restlessness accompanied by fatigue and sore throat

Rhus tox is suggested when throat pain gets better by warm drinks and warmth. It heals dry mouth, dry sore throat and aches.

Apis is suitable for stinging sore throat pain marked with swelling of the throat or tonsils.

Sulfur works on continuous sore throats. One feels discomfort due to warmth; lethargy; offensive breath, sweat, and discharges.

References

1. Wood N, Menzies R, McIntyre P. Epiglottitis in Sydney before and after the introduction of vaccination against Haemophilus influenzae type b disease. Intern Med J. 2005, 35 (9):530-5.

2. Berg S, Trollfors B, Nylén O, Hugosson S, Prellner K, Carenfelt C. Incidence, aetiology, and prognosis of acute epiglottitis in children and adults in Sweden. Scand J Infect Dis. 1996, 28 (3):261-4.

3. Guldfred LA, Lyhne D, Becker BC. Acute epiglottitis: epidemiology, clinical presentation, management and outcome. J Laryngol Otol. 2008, 122 (8):818-23.

4. Chan KO, Pang YT, Tan KK. Acute epiglottitis in the tropics: is it an adult disease?. J Laryngol Otol. 2001,115 (9):715-8.

5. Faden H. The dramatic change in the epidemiology of pediatric epiglottitis. Pediatr Emerg Care. 2006, 22 (6):443-4.

6. Katori H, Tsukuda M. Acute epiglottitis: analysis of factors associated with airway intervention. J Laryngol Otol. 2005, 119 (12): 967-72.

7. Ehara H. Tenderness over the hyoid bone can indicate epiglottitis in adults. J Am Board Fam Med. 2006, 19 (5):517-20.

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