Epiglottitis

DEFINITION

Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis — a small cartilage “lid” that covers your windpipe — swells, blocking the flow of air into your lungs.

A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to your throat and various infections. The most common cause of epiglottitis in children in the past was infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia, meningitis and infections in the bloodstream. Epiglottitis can occur at any age.

Routine Hib vaccination for infants has made epiglottitis rare, but epiglottitis remains a concern. If you suspect that you or someone in your family has epiglottitis, seek emergency help immediately. Prompt treatment can prevent life-threatening complications.

CAUSES

Epiglottitis is caused by an infection or an injury.

Infection

A common cause of swelling and inflammation of the epiglottis and surrounding tissues is infection with Haemophilus influenzae type b (Hib) bacteria. Hib is responsible for a number of serious conditions, the most common of which is meningitis.

Hib spreads through infected droplets coughed or sneezed into the air. It’s possible to harbor Hib in your nose and throat without becoming sick — though you still have the potential to spread the bacteria to others.

Other bacteria and viruses also can cause inflammation of the epiglottis, including:

• Streptococcus pneumoniae (pneumococcus), another bacterium that can cause meningitis, pneumonia, ear infections and blood infection (septicemia)
• Streptococcus A, B and C, a group of bacteria that also can cause diseases ranging from strep throat to blood infections

Injury

Physical injury, such as a direct blow to the throat, can cause epiglottitis. So can burns from drinking very hot liquids.

You also may develop signs and symptoms similar to those of epiglottitis if you:

• Swallow a chemical that burns your throat
• Swallow a foreign object
• Smoke drugs, such as crack cocaine

SYMPTOMS

In children, signs and symptoms of epiglottitis may develop within a matter of hours, including:

• Fever
• Severe sore throat
• Abnormal, high-pitched sound when breathing in (stridor)
• Difficult and painful swallowing
• Drooling
• Anxious, restless behavior
• Greater comfort when sitting up or leaning forward

Symptoms in adults

For adults, signs and symptoms may develop more slowly, over days rather than hours. Signs and symptoms may include:

• Severe sore throat
• Fever
• A muffled or hoarse voice
• Abnormal, high-pitched sound when breathing in (stridor)
• Difficulty breathing
• Difficulty swallowing

When to see a doctor

Epiglottitis is a medical emergency. If you or someone you know suddenly has trouble breathing and swallowing, call your local emergency number or go to the nearest hospital emergency department. Try to keep the person quiet and upright, because this position may make it easier to breathe. Don’t try to examine the person’s throat yourself. This can make matters worse.