Diseases & Conditions

Epiglottitis

Epiglottitis is a 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 is infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia and meningitis.

Routine Hib vaccination for infants has made epiglottitis uncommon, but it 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 of epiglottitis.

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. Don't try to examine the person's throat yourself. This can make matters worse.

If the medical team suspects that you have epiglottitis, the first priority is to ensure your airways are open and you're receiving enough oxygen.

Once your condition is stable, the doctor may examine your throat using a flexible fiber-optic tube. A local anesthetic can help relieve any discomfort. Sometimes you may have a chest or neck X-ray as well. Because of the danger of sudden breathing problems, children may have X-rays taken at their bedside rather than in the radiology department — but only after the airway is protected.

You're also likely to have a blood test and throat culture. For the culture, your epiglottis is wiped with a cotton swab and the tissue sample is checked for Hib. Blood cultures are usually taken because sepsis — a severe infection — often accompanies epiglottitis.

Epiglottitis can lead to respiratory failure — a life-threatening condition in which the level of oxygen in the blood drops dangerously low or the level of carbon dioxide becomes excessively high.

Sometimes the bacteria that cause epiglottitis cause infections elsewhere in the body, such as pneumonia, meningitis or a blood infection (sepsis).

Rarely, pulmonary edema, another life-threatening condition, can develop. It occurs when the tiny air sacs in the lungs fill with fluid, preventing them from absorbing oxygen.

The first priority in treating epiglottitis is ensuring that you're receiving enough air. You may wear a mask that delivers oxygen to your lungs, but it's more likely that you'll have a breathing tube placed into your windpipe through your nose or mouth. The tube must remain in place until the swelling in your throat has decreased — sometimes for several days.

In extreme cases or if more conservative measures fail, the doctor may need to create an emergency airway by inserting a needle directly into an area of cartilage in your trachea. This procedure, called a tracheotomy, allows air into your lungs while bypassing the larynx. The needle is removed as soon as the airway is open.

If your epiglottitis is related to an infection, you'll receive intravenous antibiotics once you're breathing freely. Until your doctor knows the results of your blood and tissue cultures, you're likely to be treated with a broad-spectrum drug. You may receive a different antibiotic later, depending on what's causing your epiglottitis.