Epiglottitis In Children

It is an infectious disease that is characterized by edema and inflammation of the epiglottis (valve on windpipe), which is usually seen in children (most frequently between age of 2 and 7) and less frequently in adults and is characterized by acute, serious and if it has inappropriate treatment, it has high mortality.

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Clinic

The disease begins with fever and sore throat and refusal to feed. Within a few hours, salivation increases due to the inability of the secretions to swallow, followed by wheezing breathing. As the younger age you are, the earlier the respiratory distress develops. Children usually need to lean their head backward (tripod seat) to relieve breathing.

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Typical Clinical Triad Symptom

  • Saliva flow from mouth,

  • Dysphagia (painful swallowing),

  • Respiratory distress.

Fever and hoarseness are common, coughing is rare. The epiglottis appears as swollen and red. During the examination, the patient should be sitting in a position to keep the respiratory tract opening.

Unwanted Effects

The co-existence of other Hib infections such as respiratory tract obstruction, meningitis, pneumonia is an indication that it is severe.

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Diagnosis

Clinical diagnosis is usually sufficient. Especially in patients who are extremely ill, applying pressure to the tongue base during the oral examination may increase epiglottis edema, leading to a death of the patient. Leukocytosis (increase in the white blood cell count) frequently occurs in the whole blood (hemogram, CBC) count. X-ray films can help diagnose. Side-neck film taken at the soft tissue dose may show thumb view, hypopharynx dilation and spinal lordosis (neck curve). However, in severe cases, it should not delay the treatment in order to have a film.

Blood culture must be taken absolutely. The taken culture from epiglottis is useful but can be done after you are sure the respiratory tract is open. Tests showing Hib antigen can be used when antibiotics are used.

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