Epiglottitis
Epiglottitis is a life-threatening infection of the upper airway of children. Patients present with sore throat, fever, drooling, difficulty swallowing, and respiratory stridor. Haemophilis influenza type b (Hib) vaccine in recent decades has reduced this to a rare condition.
CASES/YEAR
6,000 (US); 120,000 (Global)
OTHER NAMES
Supraglottitis;
INCUBATION
Estimated: 1-5 days;
INITIAL SYMPTOMS
Sore throat, fever, drooling, difficulty swallowing, and respiratory stridor--high risk of airway obstruction;
PRECAUTIONS
Haemophilis influenzae type b: Droplet until 24 hours after initiation of effective therapy;
COMMENTS
Haemophilis influenza type b (Hib) vaccine in recent decades has reduced this to a rare condition. Direct visualization shows a cherry red epiglottis--examine only if setup for emergency airway control. Accompanying pneumonia on chest x-ray in up to 25%; [ABX Guide]
DIAGNOSTIC
Clinical; "Diagnosis requires direct visualization of the supraglottic structures, which is not to be done until full respiratory support is available." Lateral neck soft tissue x-ray in milder cases with low suspicion; [Merck Manual, p. 840-1]
SIGNS & SYMPTOMS
-
>fever
-
E dysphagia
-
E pharyngitis
-
H leukocytosis
-
H lymphadenopathy
-
R dyspnea
-
*pneumonia
RISK FACTORS
- Fail to complete immunizations
REFERENCES FOR CASES/YEAR
1. (US) 0.9 to 3.1 per 100,000; [Gorbach, p. 176] Calculate: 2 x 3000 = 6000 (US); 2 x 60,000 = 120,000 (worldwide);
2. (Global) 20 X US cases/yr;