Diseases

Epiglottitis (Inflammation of the Back of the Gum) – Causes, Symptoms & Treatment

Epiglottitis (Kehldeckelentzündung)

Epiglottitis – also inflammation of the epiglottis – is a disease caused by bacteria. Although this disease is rare in the 21st century, immediate action is required when it is suspected, as it is life-threatening and, if left untreated, can lead to death. Epiglottitis is most common in children under the age of 6, but adults can also contract epiglottitis.

What is epiglottitis?

Epiglottitis is a bacterial infection that can lead to life-threatening inflammation of the epiglottis. The epiglottis is part of the larynx and separates the trachea from the esophagus. When you swallow, the epiglottis covers the entrance to the larynx and blocks the trachea, allowing food and liquid to enter the esophagus.

In epiglottitis, the mucous membranes of the epiglottis swell as well as the surrounding tissue, such as the muscles of the larynx or the lower pharynx. This massive swelling can partially or completely block the trachea, which can lead to acute shortness of breath or suffocation. Epiglottitis should not be confused with pseudocroup , which has similar symptoms. As a rule, children of preschool age develop epiglottitis, less often adults. Epiglottitis occurs only in humans.

causes

Epiglottitis is caused by bacterial infection. However, the cause or bacterium for epiglottitis is different in children and adults.

In children, the cause is usually an infection with the bacterium “Haemophilus influenzae type B”. The pathogen is transmitted by so-called contact or droplet infection . In adults, epiglottitis is often caused by pneumococci . The pathogens are “Streptococcus pneumoniae” and “Staphylococcus aureus”.

Epiglottitis often occurs without any other preceding condition. In exceptional cases, there may have been an untreated infection of the nasopharynx which has spread. Due to thorough vaccination measures, however, epiglottitis is only rarely found.

Symptoms, Ailments & Signs

Acute epiglottitis is a fulminant clinical picture in which severe symptoms develop within a few hours. A high fever and a rapid deterioration in the general condition typically occur with complete health . The swelling of the epiglottis leads to a sore throat and painful swallowing problems with increased salivation .

The children can no longer or do not want to speak and refuse solid and liquid food. The saliva typically runs out of the mouth. Another major symptom of epiglottitis is inspiratory stridor, a wheezing sound that occurs during inspiration. This is followed by a snoring exhalation, the so-called rattling breathing.

The increasing swelling of the epiglottis results in obstruction of the upper respiratory tract with increasing shortness of breath . To facilitate breathing, patients assume a typical posture. Sitting with your upper body bent forward, you tilt your head back and breathe with your mouth open to widen your airways.

The changed language is also noticeable. It impresses as a “lumpy”, often painful way of speaking. Swollen lymph nodes can often be felt in the neck and head area. Cough, on the other hand, is an atypical symptom of acute epiglottitis and occurs rather rarely.

Diagnosis & History

Epiglottitis is diagnosed by the doctor. You can recognize them by symptoms such as shortness of breath, high fever, heavy salivation, severe sore throat and pain when swallowing. Other signs include refusing to eat, having trouble speaking, and refusing to lie on your back.

Palpation of the neck reveals severely swollen lymph nodes. If these symptoms are less pronounced, the infection can be detected by means of a blood count. The blood sample can also be used to determine the type of pathogen, which enables more precise treatment of epiglottitis.

The symptoms of epiglottitis develop and worsen over a few hours, so the patient is immediately referred to the hospital because of the symptoms alone. Since the mucous membranes around the epiglottis swell very significantly in epiglottitis, severe shortness of breath occurs in the further course, which can lead to death by suffocation. If the disease is treated in time, the epiglottitis usually heals without consequences.

When should you go to the doctor?

If you have persistent shortness of breath or breathing problems, you should see a doctor. If there are interruptions during the night’s sleep due to breathing difficulties, a doctor’s visit is necessary immediately.

If the person concerned suffers from a sore throat, a feeling of tightness in the throat or severe swallowing difficulties, these symptoms must be examined and treated by a doctor. A doctor’s visit should take place if the vocalization is interrupted or the voice sounds persistently hoarse. If the supply of food is not possible for several days or if it is vehemently refused, there is a risk of an undersupply of the organism.

A doctor’s visit is necessary to initiate medical treatment. Refusing to drink fluids increases the risk of dehydration. This can be a life-threatening condition that needs to be treated as soon as possible. As soon as the affected person notices that the mucous membranes in the mouth and throat area swell, he should consult a doctor.

In the event of a general feeling of illness, noticeable malaise or physical weakness, it is advisable to consult a doctor. If symptoms such as dizziness, unsteady gait or disturbances of consciousness occur, a doctor’s visit is urgently required. Heart rhythm problems, tachycardia or high blood pressure are causes for concern. In order not to trigger life-threatening conditions or permanent damage, you should see a doctor as soon as possible.

Treatment & Therapy

If there is a suspicion of epiglottitis, the patient must be taken to the hospital immediately so that adequate therapy can be given in good time. There are certain things to keep in mind when you are being transported to the hospital. The transport route should be as short as possible and should be accompanied by a doctor or an emergency doctor.

Due to the swelling, breathing is impaired, so an upright sitting position is important. Sick people easily panic due to the reduced breathing, so that one should always have a calming effect on the patient. Sedatives are contraindicated in epiglottitis as they adversely affect breathing.

The top priority in epiglottitis is to keep the airways clear. As a rule, an intubation takes place, which should take place as early as possible. A tube is inserted into the trachea, which is used for further ventilation. As a further measure, so-called adrenaline sprays can also be administered to reduce the swelling. In extremely serious cases, in which the airways are so swollen that intubation is no longer possible, a tracheotomy, a so -called windpipe incision , is performed.

After securing the airway, epiglottitis is treated with antibiotics. In children, the bacterium is treated with the active ingredient cefotaxime, in adults with cefuroxime. So-called corticosteroids are also used, which have a decongestant and anti-inflammatory effect. Treated in time, the epiglottitis heals without consequences.

Outlook & Forecast

The prognosis of epiglottitis is linked to the progression of the disease at the time of diagnosis. If the inflammation is detected and treated in good time, the symptoms will be alleviated within a few days. Normally, the disease is completely cured within a few weeks. The patient is symptom-free and does not have to expect any consequential damage.

The course of treatment may be longer if there are other diseases that also weaken the immune system or the patient has an unhealthy lifestyle. In these cases there are too few defenses in the organism. As a result, the effect of the drug is delayed to the extent necessary.

If the epiglottitis is in an advanced stage, there is a risk of serious complications. In addition to hoarseness, pain and other complaints, the patient can die. The disease is fatal in 10-20% of those affected. The patient is at risk of suffocation if medical care is not provided or is used late.

If there is a collapse or acute shortness of breath , an emergency doctor is needed. Depending on the patient’s condition, he or she can place an artificial ventilation access as part of a life-saving measure or an emergency operation. Drug treatment is then initiated. The patient must remain in the hospital until the inflammation subsides. Timely treatment is therefore essential for a good prognosis.

prevention

Epiglottitis is caused by bacteria. The disease can be prevented by vaccination . The vaccination called Haemophilus influeanzae type B – commonly known as Hib – is recommended for infants by the STIKO (Standing Vaccination Committee of the Robert Koch Institute). As a so-called combination vaccination, the active ingredient against epiglottitis is injected together with other childhood diseases.

You can do that yourself

Children who suffer from epiglottis often wake up at night and panic because they are not getting enough air. So that the shortness of breath does not increase further due to the fear, it is important to have a calming effect on the child.

Support quiet conversations with the child and physical closeness so that the child can breathe slowly again. In the bedrooms, a window should be open overnight so that there is always enough oxygen in the room. In the case of a nocturnal attack of shortness of breath, the window should be opened wide. The fresh air is helpful as the coolness helps reduce swelling of the mucous membranes.

In addition, it can be perceived as pleasant when hot water is turned on in the bath or shower. The increased humidity creates a calming feeling. However, the success of this method has not been statistically proven.

Loud talking and screaming should be avoided if you have epiglottitis. Spicy foods such as chilli or pepper are not recommended. These also irritate the respiratory tract and lead to an increase in symptoms. The consumption of harmful substances such as nicotine and alcohol should also be avoided. They also attack the airways and impair the ability of the larynx to function.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.