Causes Of Epiglottitis In Children, Symptoms And Treatment

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Epiglottitis in children is characterized by swelling and inflammation of the epiglottis. It could be a bacterial or viral infection. The epiglottis is flap-like elastic cartilage that is present behind the throat, at the base of the tongue. The main function of the epiglottis is to prevent food from entering the windpipe (trachea) while swallowing (1).

Epiglottitis is a condition that requires medical attention and must be reported to a doctor. However, vaccination can prevent the condition, and several other preventive measures might also help.

Read on to know more about symptoms, causes, complications, diagnosis, and prevention of epiglottitis in children.

Symptoms Of Epiglottitis In Children

The following are some of the most commonly noticed symptoms of epiglottitis in children (1)(2)(3).

  • No cough (Important sign, epiglottitis has no cough)
  • Upper respiratory tract infections
  • Sudden onset of severe sore throat
  • Fever
  • Muffled voice
  • Drooling
  • Irritability and restlessness
  • Inability to talk
  • Sitting in a forward-leaning position
  • Keeping their mouth open
  • Cyanosis (bluish discoloration of the skin)
  • Stridor (a high pitched sound heard during inhalation and exhalation)

Note that each child may experience different symptoms. Furthermore, while the main symptoms of epiglottitis in young children include breathing difficulties, stridor, and a hoarse voice, the most common symptoms in older children include swallowing difficulties and drooling.

Risk Factors And Causes Of Epiglottitis In Children

The most common cause of epiglottitis in children is a bacterial infection of the upper respiratory tract (1). In most cases, Haemophilus influenzae type B (HIB) is the bacteria responsible, and in some cases, it can be caused by the group A ß-hemolytic streptococci bacteria.

The precise reason a few children develop this infection, while others do not, is not known. The following are some other possible causes of epiglottitis (4).

  • Fungal infections in children with weak immune systems
  • Viral infections from varicella zoster or herpes simplex virus
  • Injury to the throat by a physical blow or due to consuming a very hot liquid
  • Chemical burns
  • Side effects caused by other diseases or chemotherapy

Epiglottitis affects males more than females at an approximate ratio of 2.5 to 1 and is most common in children aged two to six years (4)(5).

Diagnosis Of Epiglottitis In Children

Epiglottitis is a serious medical emergency, and it is of primary importance to ensure that the child is able to breathe. The healthcare providers will first stabilize the breathing and then check the child’s airway.

In most cases, physical examination is enough to confirm the diagnosis of epiglottitis. However, in some cases, the child may need a laryngoscopy or X-ray. Blood and throat cultures may also be recommended to identify the bacteria (1)(4).

Note: Refrain from checking the child’s throat at home as it might increase swelling and lead to full upper airway obstruction.

When To See A Doctor?

Epiglottitis is a life-threatening condition that can cause severe complications such as cardiac arrest or even death (5). Call emergency care right away if you think your child has related symptoms. And while the ambulance arrives, ensure you try to keep the child calm.

Treatment For Epiglottitis In Children

Emergency intervention for epiglottitis involves stopping the airway from being blocked. The sooner the intervention, the better the results. The healthcare providers may insert a breathing tube in the throat and beyond the swelling to deliver oxygen into the child’s lungs. They may also use a ventilator to enable breathing.

Treatment may also include the following (5).

  • IN (intravenous) antibiotics are given in the case of a bacterial infection.
  • Steroids may be prescribed to ease the swelling of the airway.
  • IV fluids are administered until the child can swallow food and liquid again.

Once the airway is established and antibiotics are started, epiglottitis ceases to worsen within 24 hours. However, full recovery may take longer and depend on the child’s condition.

Prognosis Of Epiglottitis

Most people with epiglottitis recover in about a week and leave the hospital in five to seven days, and fewer than one in a hundred patients succumb to death (4).

Prevention For Epiglottitis In Children

The following tips may help prevent epiglottitis in children (5).

  • The child must be given a full series of Hib vaccination according to the doctor’s suggestions. Children vaccinated with Hib vaccine are at a lower risk of contracting the infection.
  • Experts recommend three to four doses of the Hib vaccine for infants. The vaccine is administered at the age of two, four, and six months. However, it may differ according to the brand of the vaccine. A booster is also given at 18 months of age.
  • Frequent hand washing and avoiding touching the eyes, nose, and mouth can help in avoiding epiglottitis.
  • Let your child’s healthcare provider know if your vaccinated child comes in contact with a child who has epiglottitis.

Epiglottis in children can be bacterial or viral, and it is a life-threatening infection that can lead to cardiac arrest and other complications or even death. The attending physician may prescribe rifampin to protect the infected child’s family members from catching the infection. While the Hib vaccine can help prevent this infection in children, other preventive measures, such as frequent handwashing, may also be beneficial. If you suspect your child has epiglottitis, don’t ask them to lie down on their backs or have their throats examined. Instead, take your child to the doctor for immediate medical help, which is critical for better health results.

Key Pointers

  • Fever and upper respiratory tract infections with no cough are some of the most common epiglottitis symptoms in children.
  • In most cases, epiglottitis in children is caused by a Haemophilus influenzae type B (HIB) bacterial infection.
  • Epiglottitis is a life-threatening disease that can lead to serious consequences, including cardiac arrest or death.
  • Therefore, keeping the airway from being clogged is an emergency intervention for epiglottitis.

References:

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Dr. Arva M Bhavnagarwala

(MBBS, DNB)
Dr. Arva Bhavnagarwala has completed her post-graduation from Masina Hospital in Mumbai. She has worked at Jaslok Hospital and Research Center as a Clinical Associate. Currently, she practices Pediatrics at her private clinic in South Mumbai and is attached to Masina Hospital as a consultant pediatrician. Dr. Bhavnagarwala is a National Advisory Board Member of Indian Pediatrics, the official publication... more

Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. She also holds a certificate in lactation counselling from iNational Health... more