Epiglottitis: Difference between revisions

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==Cause==
==Cause==
Epiglottitis involves [[bacteria]]l [[infection]] of the epiglottis, most often caused by ''[[Haemophilus influenzae]]'' type B, although some cases are attributable to ''[[Streptococcus pneumoniae]]'' or ''[[Streptococcus pyogenes]]''.


==Symptoms==
==Symptoms==

Revision as of 13:15, 26 September 2012

Epiglottitis
Epiglottitis, Acute, Viral Etiology; Sudden Stridor and Obstruction in a Child.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology
ICD-10 J05.1
ICD-9 464.3, 476.1
DiseasesDB 4360
MedlinePlus 000605
MeSH D004826

Epiglottitis Microchapters

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Differentiating Epiglottitis from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Cause

Symptoms

Epiglottitis typically affects children, and is associated with fever, difficulty swallowing, drooling, and stridor. It is important to note however that since the introduction of the Hemophilus Infuenzae vaccination in many Western countries (including th UK), the disease is becoming relatively more common in adults. The child often appears acutely ill, anxious, and has very quiet shallow breathing with the head held forward, insisting on sitting up in bed. The early symptoms are insidious but rapidly progressive, and swelling of the throat may lead to cyanosis and asphyxiation. Cases in adults are most typically seen amongst abusers of crack cocaine and have a more subacute presentation.

Diagnosis

Diagnosis is confirmed by direct inspection using laryngoscopy, although this may provoke airway spasm. The epiglottis and arytenoids are cherry-red and swollen. The most likely differential diagnostic candidates are croup, peritonsillar abscess, and retropharyngeal abscess.

On lateral C-spine X-ray, the thumbprint sign is a finding that suggests the diagnosis of epiglottitis.[1]

Treatment

Epiglottitis requires urgent endotracheal intubation to protect the airway. Ideally, this should be performed by an experienced anesthesiologist or respiratory therapist, with otolaryngology back-up in case of failed intubation. If intubation fails, tracheotomy is required.

In addition, patients should be given an antibiotic drug such as ceftriaxone or chloramphenicol either alone or in association with penicillin or ampicillin for streptococcal coverage.

Complications

Some patients may develop pneumonia, lymphadenopathy or septic arthritis.

References

  1. Jaffe JE. Acute Epiglottits. eMedicine.com. Available at: http://www.emedicine.com/Radio/topic263.htm. Accessed on: December 21 2006.

External links

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