EPIGLOTTITIS

The  epiglottis  is  a  piece  of  cartilage  that  sticks  up  at  the  back  of  the  tongue  to  stop  food  from  entering  the
windpipe  (trachea)  when  swallowing.  Epiglottitis  is  an  uncommon  bacterial  infection  (most  commonly  by
Haemophilus  influenzae B  - HiB) of the epiglottis that is an acute medical emergency requiring urgent

hospitalisation, as  it  can  swell up  rapidly and block  the  throat.    Infection  is most  common  in  children under  five
years of age who develop a very sore  throat,  fever and obvious  illness.  In young children,  if  the epiglottis swells
excessively,  or  is  disturbed  by  trying  to  eat  solids  or  by  the  tongue  depressing  stick  of  a  doctor  examining  the
mouth, it can cover the windpipe completely and rapidly cause death through suffocation. For this reason a doctor
will give the throat only a cursory examination before arranging the immediate transfer of the child to hospital. If the
airway is obstructed in hospital, an emergency tracheotomy (an operation to make a hole into the wind pipe through
the front of the neck) is performed to allow the child to breathe.
The diagnosis is confirmed by a side-on X-ray of  the neck  that shows  the swollen epiglottis. Throat swabs are
taken to identify the infecting bacteria, and sometimes blood tests are also performed.
Antibiotics are given  to cure  the  infection and paracetamol  to  reduce  fever and pain. Some hospitals  routinely
anaesthetise children and put a  tube  through  the mouth or nose and down  the  throat  to prevent  the airway  from
blocking.  The  infection  usually  settles  in  a  few  days,  and  provided  there  has  been  no  airway  obstruction,  the
outcome is excellent. A series of vaccinations against Haemophilus influenzae B (HiB) is now routinely given to all
children starting at two months of age.