What Is It?

The epiglottis is the flap of tissue located just above the windpipe (trachea) that directs the flow of air and food in the throat. When we breathe, the epiglottis is positioned so that air goes into the lungs. When we eat, the epiglottis is positioned differently to cover the top of the windpipe, so that food goes into the swallowing tube (esophagus), and not into the lungs.

Epiglottitis is a rare, but potentially life-threatening infection. It causes swelling of the epiglottis, which often progresses rapidly, sometimes within hours. If treatment is delayed, the epiglottis can become so large that it blocks off the windpipe, interferes with breathing, and can result in death.

Epiglottitis can occur at any age. Until 1985, epiglottitis occurred most commonly in children aged 3 to 7, but the development of a vaccine against Haemophilus influenzae type b (Hib) has made epiglottitis increasingly rare in children in the United States.

The most common signs and symptoms of epiglottitis include:

• Severe sore throat that comes on suddenly
• Fever
• Shortness of breath or difficulty breathing, especially when lying down
• Drooling and difficulty managing saliva in the mouth
• A type of noisy breathing called stridor, which is a loud sound heard only when breathing in
• Difficulty swallowing
• Muffled voice

Epiglottitis is an emergency! If you think your child has this infection, seek emergency help immediately. There needs to be adequate equipment and personnel to handle this potential breathing emergency. Pressing on the tongue to look down the throat may cause the epiglottis to swell more and further block the airway. Never try to look down the throat of a person who is suspected of having epiglottitis.

X-rays of the neck sometimes can show an enlarged epiglottis, but the time needed to perform the X-rays may delay other important tests and treatment.

After doctors in the hospital confirm that the epiglottis is inflamed, the airway is kept open using a breathing tube. Blood tests and/or throat swabs are performed to determine which organism is causing the infection.

Most patients begin to recover within 24 to 48 hours after receiving antibiotics. Breathing tubes usually can be removed soon after that, and it may take up to a week or more to recover completely.

Most cases of epiglottitis in children can be prevented by having children vaccinated against Hib and pneumococcal infections.

Epiglottitis should be treated in the hospital so that the patient’s breathing can be monitored. If the patient is having trouble breathing, he or she may need to have a breathing tube placed in his or her throat.

Antibiotics should be administered immediately after the patient’s breathing is stabilized and blood samples and throat swabs are taken. Antibiotics usually are given at first through an intravenous line (into a vein) Once the infection is under control, antibiotics can be taken by mouth until treatment is complete. Additional medicines may be given to control fever and pain.

Call an ambulance at the first sign of unexplained breathing difficulty, especially if it is accompanied by a sore throat, fever, drooling or noisy breathing.

With proper treatment, patients usually recover completely. The key, however, is early recognition of the signs and symptoms, so that treatment can be started before difficulties begin.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.