Epiglotitis is swelling and inflammation in the epiglottis. Epligottis is a leaf-shaped valve that functions to cover the trachea ( windpipe ) so that food or fluid is not entered when we swallow. The valve is located behind the base of the tongue.
This inflammation can affect anyone of all ages. However, children aged 2 to 5 years are the group that experiences it most often. People with weakened immune systems (eg HIV sufferers or chemotherapy patients) and people who have not received Haemophilus influenzae type b (Hib) vaccination also have a higher risk of epiglotitis.
Symptoms of Epiglotitis
In children, epiglotitis symptoms tend to worsen quickly, even within hours. In contrast to adult patients, symptoms generally appear and deteriorate slowly. Symptoms of epiglotitis include:
- Severe sore throat.
- Pain and difficulty swallowing.
- Difficulty breathing.
- Prefer to sit upright with the body leaning forward. Because at this position, sufferers are easier to breathe.
- Loud breath sounds.
- Drooling (drooling).
Because the symptoms are similar, this disease is often suspected of croup (laryngotrakeobronchitis), which is an infection of the voice box and throat caused by a virus that is often experienced by children. But keep in mind that epiglotitis is more dangerous. If it is not immediately treated, the epiglottis can swell and cover the trachea, which inhibits oxygen supply and leads to death.
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Causes of Epiglotitis
Bacterial infections are the main cause of epiglotitis. S treptococcus pneumoniae and Haemophilus influenzae type B (Hib) are the types of bacteria that most often trigger inflammation in the epiglottis.
The infection will cause the epiglottis to swell and block the entry of air in the respiratory tract and potentially cause death.
In addition to infections, cuts to the throat can also cause inflammation and swelling of the epiglottis. For example, due to collisions or punches, foreign objects or chemical compounds that are ingested, and the use of illegal drugs that are smoked.
People who are suspected of having epiglotitis must be taken to the hospital immediately because they need emergency treatment. The main priority in treatment is to make sure the respiratory tract is open so that it can be passed by oxygen. An example is by attaching an endotracheal tube by mouth.
If the epiglottis covers the trachea so that the installation of an oral endotracheal tube is difficult, or in an emergency where the airway must be opened as soon as possible, a tracheostomy tube can be attached , through a hole made in the patient's neck directly into the trachea.
A new follow-up is performed after breathing has stabilized. Some of them are:
- Examination of the throat with laryngoscopy or nasopharyngoscopy, to see the condition of the epiglottis.
- Blood test, to see signs of infection.
- Laboratory tests with epiglottis tissue samples, to check for viruses or bacteria.
- Chest or neck X-ray.
- CT or MRI scans, if the results of scanning in other ways do not provide a clear enough picture.
If epiglotitis is caused by a bacterial infection, the treatment is antibiotics. To reduce swelling and inflammation, steroid drugs can be given.
Prevention of Epiglottitis
The Hib vaccine is the main prevention of epiglotitis. In Indonesia, this vaccine is given in conjunction with DPT and hepatitis B, and is referred to as the Pentabio vaccine. Giving this vaccine has 4 stages, namely when babies are 2, 4, 6, and 18 months. For children who are coming for the first time at the age of 1-5 years, this vaccine is only given once.
Preventing the spread of Hib infections can help prevent epiglotitis. Therefore, antibiotics are sometimes also given to people who live in homes with sufferers as prevention.