Acute epiglottitis (infectious inflammation of the laryngeal flap) is a life-threatening bacterial infection affecting mostly young children (toddlers and preschoolers).
The cause of the disease is a bacterium known as haemophilus. It causes a wide range of infectious diseases, especially infections of the upper respiratory tract. The infection is usually transmitted by air and the inhaled bacteria affect and multiply in the respiratory mucosa. The epiglottitis develops in case the bacteria attack the laryngeal flap. Laryngeal flap separates the airways from the digestive tract and prevents us to aspirate food or fluids during swallowing.
The laryngeal flap swells and narrows the airways. The initial flu-like symptoms include fever, sore throat, pain during swallowing and cough followed by worsening shortness of breath. The child is suspiciously quiet and obedient as it is unable to breathe during physical exertion. The child does not tolerate horizontal position, because lying further narrows the airways. If we there is a suspicion of epiglottitis, the child should be immediately taken to the hospital!
Diagram - Epiglottis affected by local inflammation
The diagnosis can be made from presence of above mentioned symptoms and otolaryngological examination when the physician sees the swollen and reddish laryngeal flap obstructing the entrance to trachea. The diagnosis can be further confirmed by a laryngeal swab sent to microbiological examination.
The best prevention is vaccination at the present time. The vaccine has a good effect and it distinctively decreased number of epiglottitis cases in countries with a widespread vaccination program.
The child should be monitored in an inpatient department. Antibiotics are the therapy of first choice; the doctors sometimes administer the corticosteroids to reduce the swelling of the tissue. Oxygen therapy helps to support the cardiopulmonary system. In case of threat of suffocation, intubation is sometimes necessary to secure the airways.