Have you ever suddenly felt a severe pain in your throat that made it so difficult to swallow even a little saliva? At the same time, do you feel a little difficult to breathe? This condition, especially if it occurs in a small child, makes us very scared as parents. Today we are talking about a condition called Epiglottitis, which causes these symptoms and is considered a medical emergency.
Simply put, what is epiglottitis?
Okay, let's put it this way. At the base of our tongue, inside our throat, there's a little flap of cartilage called the epiglottis. Its main job is to prevent things from entering our windpipe when we eat or drink. It's like a door, closing the windpipe when we swallow.
Epiglottitis is when, for some reason, often a bacterial infection, the epiglottis becomes swollen, red, and infected.
Imagine, what happens if this little door that closes our airway swells? The airway starts to get blocked. This is the most dangerous thing about this disease. If the airway becomes completely blocked, it can even be life-threatening.
In the past, this disease was very common among young children. The cause was the bacterium Haemophilus influenzae type b (Hib). However, now that the Hib vaccine is included in the vaccination series given to children in our country, this disease is very rare among children. Therefore, now this condition is somewhat seen among adults. However, since children's respiratory tracts are very small, it is more dangerous if they contract this.
What are the main causes of Epiglottitis?
As I said before, the main cause of this is a bacterial infection . Among them, the following are the most common:
- Haemophilus influenzae
- Streptococcus pneumoniae
- Streptococcus groups A, B, and C
- Staphylococcus aureus
In addition to these bacterial infections, this condition can sometimes be caused by fungal infections. Also, after a viral infection (e.g. chickenpox) in a person with a weakened immune system, a bacterial infection can develop and cause epiglottitis.
In addition to infections, there are other causes. These include:
- Throat injuries: Burning the throat from drinking very hot food or liquid, inhaling or swallowing a chemical, smoking (especially crack cocaine), or external trauma to the throat.
- Other illnesses: This can also occur as a side effect of some cancer treatments.
Is this disease contagious?
Yes. The bacteria or virus that causes epiglottitis can spread through the air when an infected person coughs or sneezes. Therefore, it is very important to follow good health practices, such as washing your hands frequently and staying away from sick people.
Recognize! These are the symptoms of epiglottitis!
The most dangerous thing about this disease is that the symptoms can become severe very quickly, within a few hours. It doesn't take long for it to start as a simple sore throat and become life-threatening.
Doctors identify four main symptoms of this disease. To make it easier to remember, they call these the "4 D's." Let's take a look at what they are.
| The letter "D" | Symptom and its meaning |
|---|---|
| Dysphagia | Difficulty swallowing: Inability to swallow even a small amount of saliva due to severe throat pain. |
| Dysphonia | Voice changes: hoarseness, stuttering, or a muffled sound as if something is stuck in the throat. |
| Drooling | Drooling: Involuntary leakage of saliva from the mouth due to inability to swallow. This is most common among young children. |
| Distress | Difficulty breathing: whistling sound (stridor) when breathing, labored breathing, restlessness. |
In addition to these four main symptoms, there may also be a high fever and great restlessness or anxiety .
The patient, especially a child, will try to lean forward and rotate their neck upward to make breathing easier. We call this the "tripod position." Lying down can make breathing even more difficult.
When should you go to the hospital immediately?
This is something to remember. If you or your child has any of the "4 D's" mentioned above, it is not an illness that can be kept at home. This is a medical emergency. Do not delay a second, go immediately to the Emergency Department (ETU) of the nearest hospital.
Especially if the skin turns blue (cyanosis), it means that the body is not getting enough oxygen. That is a very dangerous sign!
Important: Do not try to check your child's throat or put anything in their mouth at home. Doing so can increase the swelling and cause sudden airway obstruction. Keep your child calm, sitting up, and breathing easily, and take them to the hospital immediately.
How do doctors diagnose this disease?
Diagnosing this disease is a bit risky. Because when examining the epiglottis, the airway can suddenly become blocked due to swelling. Therefore, doctors perform this examination very carefully, keeping all the necessary equipment (such as a breathing tube) nearby in case of an emergency.
- Laryngoscopy: A tube with a small camera is passed through the nose and down the throat to examine the condition of the epiglottis.
- X-ray: An X-ray of the neck can detect a swollen epiglottis.
- Blood tests: Blood tests are done to find the cause of the infection.
Can this disease be confused with other diseases?
Yes. Sometimes this disease can be confused with conditions called strep throat or croup.
| Epiglottitis | Croup |
|---|---|
| It gets worse very quickly (within a few hours). | Symptoms develop slowly over several days. |
| Severe throat pain, difficulty swallowing, and drooling are the main symptoms. | There is a characteristic barking cough, similar to a dog barking. There is less difficulty swallowing. |
| There is usually a high fever. | Often there is a low-grade fever. |
How is it treated?
If you are diagnosed with epiglottitis, you will be hospitalized immediately. The main goal of treatment is to keep your airway open.
1. Providing oxygen: If there is difficulty breathing, oxygen is given through a mask.
2. Breathing assistance: If swelling is causing a blockage in the airway, doctors may insert a tube into the windpipe through the nose or mouth (intubation) for a few days until the swelling goes down. Very rarely, if the swelling in the throat is severe, a small incision may be made on the outside of the neck and a breathing tube may be inserted (cricothyroidotomy).
3. Antibiotics: Antibiotics are started as soon as possible through a vein (IV).
4. IV fluids: Fluids such as saline are given through a vein until you can swallow normally.
5. Corticosteroids: These drugs are used to reduce swelling.
What complications can this cause?
The main and most dangerous complication is complete airway obstruction and death.
In addition, the bacteria that caused the infection can spread to other parts of the body,
- Pneumonia
- Meningitis (infection of the membranes covering the brain)
- Skin infections
- Sepsis (blood poisoning)
Severe situations can occur.
Can't it be prevented? The importance of the Hib vaccine
The good news is that there is a highly effective vaccine to protect against the Hib bacteria, the main cause of this disease. This is included in the national vaccination program for children in our country. Therefore, by giving your child all the vaccines on time, you can protect him from this dangerous disease.
This vaccine is not usually recommended for people over the age of 5. However, a doctor may recommend this vaccine for people with weakened immune systems (e.g., HIV-infected people, cancer patients).
Take-Home Message
- Epiglottitis is an infection and swelling of the epiglottis, a flap in the throat. This is considered a medical emergency because it can block the airway.
- The main symptoms are severe sore throat, difficulty swallowing, hoarseness, drooling, and difficulty breathing (the 4 D's) .
- If you have any of these symptoms, go to a hospital's Emergency Department (ETU) immediately. Do not attempt to treat yourself at home.
- Hib vaccination can largely protect children from this disease. Keep your child's vaccination card accurate.
- If diagnosed and treated promptly, most people recover completely. Delays can be life-threatening.
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