Epiglottitis

Epiglottitis is a life-threatening bacterial infection that occurs when the epiglottis — a small piece of cartilage that covers the windpipe — swells, obstructing the flow of air into your child's lungs. At Boston Children's Hospital, the Division of Infectious Diseases provides comprehensive inpatient and outpatient care for this unusual infection.

• The HiB (Haemophilus influenzae type B) vaccine, which prevents the majority of bacterial causes of epiglottitis, has made this condition very rare.
• Epiglottitis is very serious and requires immediate emergency treatment.
• Epiglottitis usually occurs in children 2 to 8 years old.

The HiB vaccine, recommended for infants at 2, 4, 6, and 15 to 18 months of age protects against the most common bacterial cause of this condition, making the condition very rare for infants.

Epiglottitis caused by the bacteria HiB can be prevented with vaccines that start at the age of 2 months. Epiglottitis caused by other organisms can't be prevented at this time, but are much less common. Most people who get the HiB vaccine don't have any problems with it. Some minor problems may include:

• Redness, warmth, or swelling in the location where the shot was given
• Fever

While symptoms may vary from child to child, the most common include:

• Quick onset of a very sore throat
• Fever
• Muffled voice
• No cough
• Drooling
• Unable to talk
• Child sits leaning forward
• Child keeps his mouth open
• Difficulty breathing

Because of the severity of the disease and the need for immediate care, the diagnosis is usually made on physical appearance and a thorough medical history. If epiglottitis is suspected, your child will need to immediately be seen in the emergency room.

At the hospital, the following tests may be performed to confirm the diagnosis:

• X-ray of the neck
• Blood tests
• Visualization of the airway

Epiglottitis requires immediate emergency care to prevent your child from stopping breathing. If epiglottitis is caused by a bacterial infection, antibiotics are started right away. Once your child is being monitored, the airway is safe, and antibiotics are started if appropriate, the disease usually stops progressing within 24 hours. Complete recovery takes longer and depends on each child's condition.

Treatment may include:

• Closely monitoring your child's airway
• If needed, assisting your child's breathing with machines
• Intravenous (IV) therapy with antibiotics to treat the infection
• Steroid medication (to reduce airway swelling)
• Intravenous (IV) fluids, until the child can swallow again

If your child is diagnosed with bacterial epiglottitis, your family or other close contacts may need to be treated with an antibiotic as well, to prevent the disease in those people who might have been exposed.