History | Epiglottitis

History

The onset of epiglottitis can be very sudden and rapid, regardless of age. In the beginning, the symptoms are mainly a rapidly rising fever of up to 40°C, severe difficulty swallowing and a strong salivation. As a result of the swelling of the epiglottis, patients suffer from severe breathing difficulties, which can be recognized by typical inhalation and exhalation sounds.

In addition, the inflammation can now also be seen from the outside. The larynx appears bulging and red and may have small white spots, so-called abscesses. These abscesses are accumulations of pus and are an expression of a severe inflammation.

Patients often lean forward with their upper body and place their elbows on their thighs to support their breathing. If epiglottitis is not treated, acute shortness of breath and oxygen deficiency can occur in severe cases. This situation now represents an absolute emergency.

If not treated adequately, death can occur in extreme cases. Epiglottitis is therefore a very rapidly occurring disease that can lead to a massive deterioration of the patient’s condition within a few hours and is therefore considered an emergency in medicine. During an acute epiglottitis there is a high risk of infecting other people because it is a droplet infection.

Therefore, especially with small children, strict hand hygiene must be observed. Since this is a serious disease, it has been agreed that all members of the patient’s family should take antibiotics as a prophylaxis to prevent infection. In the case of children attending kindergarten, it is highly advisable to report this to the kindergarten so that preventive measures can also be taken for the other children.

Therapy

Epiglottitis (inflammation of the epiglottis) requires immediate medical treatment. It can suddenly develop into an intensive care emergency. There is a risk of complete obstruction of the airways and thus a risk of suffocation.

For this reason, those affected should be transported to hospital immediately.It is often necessary for the affected person to have a tube inserted into the trachea (intubation) or to secure the airways with a tracheotomy. The bacterial colonization of the epiglottis is combated by intravenous antibiotic therapy. Epiglottitis should always be treated as an in-patient, i.e. in hospital.

The most important therapeutic measure is the administration of oxygen. If this is not sufficient, intubation must be considered. This is so important because the airways can suddenly swell so much that breathing becomes impossible.

Therefore, intubation should be considered early, before it is too late. Factors that speak in favor of intubation include shortness of breath with an increased breathing rate, a dry breathing sound when breathing in, an increased heart rate or a very abrupt onset of symptoms. However, the decision to intubate is made individually based on the patient’s overall clinical picture.