Diagnosis

If the medical team suspects epiglottitis, the first priority is to ensure that your or your child's airway is open and that enough oxygen is getting through. The team will monitor your or your child's breathing and blood oxygen level.

If oxygen saturation levels drop too low, you or your child may need help breathing.

Tests after stabilizing breathing

  • Throat examination. Using a flexible fiber-optic-lighted tube, the doctor may look down your or your child's throat to see what's causing the symptoms. A local anesthetic can help relieve any discomfort.
  • Chest or neck X-ray. Because of the danger of sudden breathing problems, children may have X-rays taken at their bedsides rather than in the radiology department — but only after the airway is protected. With epiglottitis, the X-ray may reveal what looks like a thumbprint in the neck, an indication of an enlarged epiglottis.
  • Throat culture and blood tests. For the culture, the epiglottis is wiped with a cotton swab and the tissue sample is checked for Hib. Blood cultures are usually taken because bacteremia — a severe bloodstream infection — may accompany epiglottitis.

Treatment

Treatment of epiglottitis involves first making sure you or your child can breathe, and then treating any identified infection.

Helping you breathe

The first priority in treating epiglottitis is ensuring that you or your child is receiving enough air. This may mean:

  • Wearing a mask. The mask delivers oxygen to the lungs.
  • Having a breathing tube placed into the windpipe through the nose or mouth (intubation). The tube must remain in place until the swelling in your or your child's throat has decreased — sometimes for several days.
  • Inserting a needle into the trachea (needle cricothyroidotomy). 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 or your child's trachea. This procedure allows air into the lungs while bypassing the larynx.

Treating infection

If your epiglottitis is related to an infection, you will be given intravenous antibiotics.

  • Broad-spectrum antibiotic. The infection needs quick treatment. So you or your child will likely receive a broad-spectrum drug right away, rather than after your doctor receives the results of the blood and tissue cultures.
  • More-targeted antibiotic. The initial drug may be changed later, depending on what's causing the epiglottitis.

Preparing for your appointment

Epiglottitis is a medical emergency; you won't have time to prepare for your appointment. The first doctor you'll see will probably be an emergency room physician.

Sept. 08, 2018
References
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