Epiglottitis

This is the medical name for inflammation of the epiglottis: the epiglottis is the thin flap of cartilage tissue which lies behind the tongue and in front of the opening to the larynx.

The epiglottis is usually in a vertical position to allow air to pass through the larynx and into the lungs. But this flap closes off when food and drink are consumed to prevent this from entering the windpipe. Once these have been swallowed the flap returns to its vertical position.

Find out more in our epiglottis section (within throat anatomy).

Causes of epiglottitis

This throat infection is caused by the ‘haemophilus influenzae Type B (Hib)’bacteria. This strain of bacteria affects both adults and children although children are especially prone to this infection due to their undeveloped immune system.

The HIB bacteria are spread in a similar manner to cold and flu viruses. This occurs through airborne droplets which contain these bacteria or onto surfaces which if touched by someone will result in them developing this infection.

Other less well known causes of epiglottitis include:

• Fungal infections
• Other types of bacterial infections
• Chickenpox virus
• Injury to the throat
• Recreational drugs such as crack cocaine (smoked)

Epiglottitis is much less common than before, thanks to the development of a vaccine designed to protect against Hib bacteria.

Symptoms of epiglottitis

These include:

• Severe sore throat
• Difficulty in breathing
• Fever/raised temperature
• Pain when swallowing
• High pitched breathing
• Drooling spit or saliva
• Hoarse or muffled sounding voice
• Cyanosis (blue colour to the skin)

These symptoms develop quite rapidly and worsen in a very short space of time.

Important: if you notice that your child develops severe breathing difficulties or is struggling to breathe then seek urgent medical advice.

Diagnosing epiglottitis

If you are the parent of a child who you suspect has epiglottitis then call an ambulance. Epiglottitis is a serious condition which can cause respiratory failure (lack of oxygen to the lungs) if left untreated.

For this reason it is considered a medical emergency which requires treatment in hospital.

Do NOT lie your child down with the aim of looking down their throat or try and insert a spatula to do so. This is very dangerous as it can trigger a spasm which will shut off their airway and is likely to be fatal. This can be fatal within a matter of minutes.

Seek medical attention as soon as possible.

Treatment for epiglottitis

This condition is treated in hospital.

At hospital the medical team will ensure that your child is able to breathe before performing an examination. This may involve a tracheostomy in which a tube is inserted into the windpipe (trachea) to keep this airway open. This is usually performed under a general anaesthetic.

Another procedure is a laryngoscopy in which a slim, fibre-optic tube, with a camera mounted at one end, is inserted into the throat.

This enables the specialist to closely examine the child’s throat.

This procedure is usually only performed on older children and adults. The problem with doing this with young children is that they will become very anxious about the procedure which further exacerbates their breathing problems.

This will be accompanied by X-rays and blood tests.

Treatment involves an intravenous course of antibiotics and oxygen to help the child breathe more easily. This oxygen is known as ‘humidified oxygen’which means that it has been moistened beforehand.

Both children and adults respond well to this treatment, usually within a few days. Children often recover within 2 to 3 days.

The good news is that children are usually vaccinated against the Hib bacteria so the chance of them developing epiglottitis is very rare.