Why drooling in epiglottitis

Any underlying infection will be treated with a course of antibiotics. With prompt treatment, most people recover from epiglottitis after about a week and are well enough to leave hospital after 5 to 7 days. Epiglottitis is usually caused by an infection with Haemophilus influenzae type b Hib bacteria.

As well as epiglottitis, Hib can cause a number of serious infections, such as pneumonia and meningitis. It spreads in the same way as the cold or flu virus. The bacteria are in the tiny droplets of saliva and mucus propelled into the air when an infected person coughs or sneezes. You catch the infection by breathing in these droplets or, if the droplets have landed on a surface or object, by touching this surface and then touching your face or mouth.

The most effective way to prevent your child getting epiglottitis is to make sure their vaccinations are up-to-date. Children are particularly vulnerable to a Hib infection because they have an underdeveloped immune system. They should receive 3 doses of the vaccine: at 8 weeks, 12 weeks and 16 weeks of age. Contact your GP if you're not sure whether your child's vaccinations are up-to-date. Read more about the NHS vaccination schedule. Because of the success of the Hib vaccination programme, epiglottitis is rare in the UK, and most cases now affect adults.

Deaths from epiglottitis are also rare, occurring in less than 1 in cases. Page last reviewed: 23 June Next review due: 23 June The main doses are given at 2 and 4 months of age or at 2, 4, and 6 months of age, based on the brand used by your healthcare provider. Your child will need a booster dose by 12 to 15 months of age.

If your child has epiglottitis, family members or other close contacts may be treated with rifampin. This medicine helps prevent the condition in people who may have been exposed to it. Epiglottitis is when the epiglottis becomes swollen and inflamed. It can be a life-threatening condition. Symptoms are usually sudden. They include severe sore throat, trouble swallowing, and problems breathing. Your child may also get antibiotics or other medicines.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child. Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are. Difficulty in breathing and stridor are common signs of epiglottitis in children, but are less frequent in adults. Laboratory tests are usually not helpful in picking up the diagnosis.

In the absence of a positive radiological finding, performing a flexible fiberoptic laryngoscopy in a controlled clinical setting for a reliable, timely diagnosis may be indicated.

From Hung TY et al. Am J Emerg Med. Epub Aug 1. Patients with signs of an advancing upper airway obstruction, consistent with an acute epiglottitis, should be treated as a medical and an airway emergency.

In the presence of respiratory distress, diagnostic procedures and radiography are not indicated, and securing the airway should be prioritized. Tracheal intubation of a patient with epiglottitis must be regarded as a potentially difficult procedure [ Figure 3 ]. It should be done in strict monitored conditions, i. The readiness of a team capable of performing an immediate tracheotomy should be verified.

The patient should be transferred to the operating room under the supervision of an experienced anesthesiologist and surgeon. The induction may be performed with the patient sitting upright.

Anesthesia induction with achievement of a deep level of anesthesia and maintenance of spontaneous ventilation has been described as the method of choice. The amount of time necessary to produce deep anesthesia using an inhalation induction may be increased secondary to airway obstruction and may necessitate increasing gas concentration. Capnography with exhaled gas analysis is useful in determining anesthetic depth.

Muscle relaxants are avoided and spontaneous ventilation should be maintained. In case of the diagnosis of epiglottitis, a fibreoptic nasal intubation or rigid bronchoscopy using an endotracheal tube with substantially reduced diameter is preferred.

The patient should be transferred sedated to an intensive care unit ICU after securing the airway. Intravenous sedation should ideally allow spontaneous ventilation. Tracheal extubation should be preceded by a cuff leak test with a deflated cuff and, usually, a second look by direct laryngoscopy with deep sedation or general anesthesia.

Complications of acute epiglottitis may include deep neck space infection, recurrent illness and vocal granuloma. The use of corticosteroids has been associated with shorter ICU and overall length of stay, with an average overall length of stay of 3. Inflammatory edema of the arytenoids, aryepiglottic folds and the epiglottis. Tracheal intubation of a patient with epiglottitis must be regarded as a potentially difficult procedure.

Acute epiglottitis is a serious condition necessitating careful and rapid intervention in order to avoid life-threatening complications. Source of Support: Nil. Conflict of Interest: None declared.

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