Cause
Epiglottitis is an inflammation of the child’s epiglottis, the flap of tissue that covers the windpipe, and is usually caused by the bacterium Hemophilus influenzae type B. Epiglottitis occurs most often in children age three to seven years, and it is more common in the fall and spring.
Symptoms
Symptoms may develop very rapidly. The child may have symptoms of an upper respiratory infection. As the epiglottis becomes inflamed and begins to swell, the throat becomes sore and painful and the child’s temperature may rise to 102 to 104 degrees Fahrenheit. The child may begin to drool because swallowing is painful. The voice may sound muffled.
Within hours, the child may develop breathing difficulty. With each breath, the child may make a high-pitched squeaking sound (stridor). The nostrils may flare out as the child breathes. The child may appear anxious and want to sit up, holding the head and neck forward to help him breathe. The lips and fingertips may start to turn blue as less oxygen gets into the bloodstream. If not treated quickly, a child with this infection may die due to blockage of the windpipe by the swollen epiglottis.
How It Spreads
The bacteria, found in nasal secretions, are spread when a person who may carry the bacteria without even being sick coughs or sneezes.
How Long Symptoms Last
Symptoms usually improve quickly with treatment, but the child usually needs to stay in the hospital for several days to a week.
When to Call Your Child’s Doctor
Bring your child to the emergency room immediately if she shows the symptoms described. Epiglottitis can be deadly if not treated quickly.
How the Diagnosis Is Made
Doctors suspect the diagnosis based on a child’s symptoms. Your child is then usually taken to an operating room where a doctor will insert a lighted thin tube into the throat to see if the epiglottis is inflamed and swollen. It may appear cherry red. The swollen epiglottis can also be seen on an X-ray of the neck.
Treatment
A specialist may insert a breathing tube into the windpipe to hold the airway open. Your child may then be placed on a ventilator (breathing machine) in the hospital to help her breathe. Intravenous antibiotics are given to kill the bacteria causing the infection. When the infection and swelling of the epiglottis subside with treatment, the breathing tube can be removed.
Prevention
The incidence of epiglottitis has decreased dramatically since the vaccine against Hemophilus influenzae type B was introduced. Infants should be immunized against this bacterium, which also causes meningitis and pneumonia. If your child develops epiglottitis, your child’s doctor may recommend that anyone in the household not fully vaccinated (except pregnant women) receive a course of the antibiotic rifampin. The doctor may recommend the same for anyone not fully vaccinated at your child’s school or child-care center.