EPIGLOTTITIS

Copyright © 1998 by W.B. Saunders Company. All rights reserved. 163 A BASIC INFORMATION DESCRIPTION A sudden, life-threatening childhood infection of the epiglottis (a small flap of tissue in the back of the throat that guards the airway entrance to the lung). Epiglottitis is contagious and is often confused with croup, which is less serious. Swelling of the epiglottis may lead to complete blockage of the airway within 12 hours of onset, so immediate treatment is necessary. FREQUENT SIGNS AND SYMPTOMS • Muffled voice or cry (in croup it is more hoarse). • Minimal cough (in croup it is a barking cough). • Sore throat. • Fever. • Hoarseness. • Drooling caused by difficulty swallowing saliva. • Increasing breathing difficulty. • Noisy, high-pitched, squeaky inhalations. • Purple skin and nails. • Odd head posture. The child tilts the neck back and leans forward with the tongue stuck out and the nostrils flared, trying to inhale more air. CAUSES Infection of the epiglottis by a bacteria (usually Haemophilus influenzae, pneumococcus or Strepto- coccus). The swollen epiglottis blocks the trachea (the main lung airway). RISK INCREASES WITH • Illness that has lowered resistance. • Crowded or unsanitary living conditions. PREVENTIVE MEASURES • If your child has had epiglottitis previously, treat all respiratory infections early and with medical super- vision. • Immunize children against hemophilus influenza. EXPECTED OUTCOMES Full recovery with prompt diagnosis and treatment. POSSIBLE COMPLICATIONS • Pneumonia, meningitis, septic arthritis, pericarditis, or cellulitis. • Without treatment, complete airway obstruction and death can occur within hours. B TREATMENT GENERAL MEASURES • Diagnostic tests may include laboratory blood culture, throat culture and others that are performed under spe- cial controls to prevent complications. • Never attempt to look at back of child’s throat if you suspect epiglottitis. • Have the child sit up rather than lie down. • Keep the child calm and still until reaching the hospi- tal. Panic increases breathing difficulty. • Hospitalization for oxygen and other intensive care. • Surgery to make an opening in the windpipe (trachea) or to place a tube in the trachea to permit breathing. Usually the tube is withdrawn or the opening is closed in 1 to 3 days. • After hospitalization, use a cool-mist ultrasonic humidifier at night in the child’s room for 2 to 3 weeks. Clean humidifier daily. MEDICATIONS • Antibiotics to control infection. Continue for a mini- mum of 10 days. • Corticosteroid to reduce inflammation. ACTIVITY Bed rest is necessary until all symptoms disappear. Activities may then be resumed gradually. DIET Fluids only (usually intravenous) until the child can swallow. After hospitalization, encourage extra fluids and provide a normal diet. C NOTIFY OUR OFFICE IF • Your child has symptoms of epiglottitis, especially signs of breathing difficulty. Or call 911. This is an emer- gency! • Your child has had epiglottitis in the past, and symptoms of respiratory infection appear. EPIGLOTTITIS

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Your child has symptoms of epiglottitis, especially signs of breathing difficulty. Or call 911. This is an emer-gency!•Your child has had epiglottitis in the past, and symp-toms of respiratory infection appear

Transcript of EPIGLOTTITIS

A BASIC INFORMATION

DESCRIPTIONA sudden, life-threatening childhood infection of theepiglottis (a small flap of tissue in the back of the throatthat guards the airway entrance to the lung). Epiglottitisis contagious and is often confused with croup, whichis less serious. Swelling of the epiglottis may lead tocomplete blockage of the airway within 12 hours ofonset, so immediate treatment is necessary.

FREQUENT SIGNS AND SYMPTOMS• Muffled voice or cry (in croup it is more hoarse).• Minimal cough (in croup it is a barking cough).• Sore throat.• Fever.• Hoarseness.• Drooling caused by difficulty swallowing saliva.• Increasing breathing difficulty.• Noisy, high-pitched, squeaky inhalations.• Purple skin and nails.• Odd head posture. The child tilts the neck back andleans forward with the tongue stuck out and the nostrilsflared, trying to inhale more air.

CAUSESInfection of the epiglottis by a bacteria (usuallyHaemophilus influenzae, pneumococcus or Strepto-coccus). The swollen epiglottis blocks the trachea (themain lung airway).

RISK INCREASES WITH• Illness that has lowered resistance.• Crowded or unsanitary living conditions.

PREVENTIVE MEASURES• If your child has had epiglottitis previously, treat allrespiratory infections early and with medical super-vision.• Immunize children against hemophilus influenza.

EXPECTED OUTCOMESFull recovery with prompt diagnosis and treatment.

POSSIBLE COMPLICATIONS• Pneumonia, meningitis, septic arthritis, pericarditis,or cellulitis.• Without treatment, complete airway obstruction anddeath can occur within hours.

B TREATMENT

GENERAL MEASURES• Diagnostic tests may include laboratory blood culture,throat culture and others that are performed under spe-cial controls to prevent complications.• Never attempt to look at back of child’s throat if yoususpect epiglottitis.• Have the child sit up rather than lie down.• Keep the child calm and still until reaching the hospi-tal. Panic increases breathing difficulty.• Hospitalization for oxygen and other intensive care.• Surgery to make an opening in the windpipe (tra-chea) or to place a tube in the trachea to permit breath-ing. Usually the tube is withdrawn or the opening isclosed in 1 to 3 days.• After hospitalization, use a cool-mist ultrasonic humid-ifier at night in the child’s room for 2 to 3 weeks. Cleanhumidifier daily.

MEDICATIONS• Antibiotics to control infection. Continue for a mini-mum of 10 days.• Corticosteroid to reduce inflammation.

ACTIVITYBed rest is necessary until all symptoms disappear.Activities may then be resumed gradually.

DIETFluids only (usually intravenous) until the child canswallow. After hospitalization, encourage extra fluidsand provide a normal diet.

C NOTIFY OUR OFFICE IF

• Your child has symptoms of epiglottitis, especiallysigns of breathing difficulty. Or call 911. This is an emer-gency!• Your child has had epiglottitis in the past, and symp-toms of respiratory infection appear.

EPIGLOTTITIS