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 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.
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
- Epiglottitis. Merck Manual Professional Version. http://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/oral-and-pharyngeal-disorders/epiglottitis. Accessed July 22, 2018.
- Protect your child against Hib disease. Centers for Disease Control and Prevention. http://www.cdc.gov/Features/HibDisease. Accessed July 22, 2018.
- Haemophilus influenzae type b (Hib) vaccine. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hib.html. Accessed July 22, 2018.
- Woods CR. Epiglottitis (supraglottitis): Clinical features and diagnosis. https://www.uptodate.com/contents/search. Accessed July 22, 2018.
- Woods CR. Epiglottitis (supraglottitis): Management. https://www.uptodate.com/contents/search. Accessed July 22, 2018.
- Hay WW, et al., eds. Respiratory tract & mediastinum. In: Current Diagnosis & Treatment: Pediatrics. 23rd ed. New York, N.Y.: McGraw-Hill Education; 2016. https://accessmedicine.mhmedical.com. Accessed July 22, 2018.
- Ferri FF. Epiglottitis. In: Ferri's Clinical Advisor 2019. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed July 29, 2018.
- Papadakis MA, et al., eds. Ear, nose, & throat disorders. In: Current Medical Diagnosis & Treatment 2018. 57th ed. New York, N.Y.: McGraw-Hill Education; 2018. http://www.accessmedicine.mhmedical.com. Accessed July 22, 2018.
- AskMayoExpert. Upper respiratory tract infection (adult and pediatric). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Steckelberg JM (expert opinion). Mayo Clinic, Rochester, Minn. July 27, 2015.
- Haemophilus influenzae disease (including Hib). Centers for Disease Control and Prevention. https://www.cdc.gov/hi-disease/clinicians.html. Accessed Aug. 9, 2018.
- Akwe JA. Pulmonary effects of cocaine use. Journal of Lung, Pulmonary & Respiratory Research. 2017;4:1.
- Staphylococcal infections. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-cocci/staphylococcal-infections. Accessed July 29, 2018.
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