Acute epiglottitis is a rare but serious infection of the epiglottis, the small flap of tissue at the base of the tongue that covers the windpipe during swallowing. It mainly affects young children and can block the airway quickly, making it a life-threatening emergency. Early recognition and urgent medical care are critical to prevent severe complications or death.
If your child shows signs of breathing difficulty or a sudden severe sore throat, Hope Plus can connect you to a licensed healthcare provider for a consultation within minutes. They can assess your child’s condition and advise whether urgent hospital care is needed. You can access this service here: Hope Plus.
Key Takeaways
- Acute epiglottitis is a rare but potentially life-threatening infection of the epiglottis.
- Symptoms develop rapidly and include high fever, difficulty swallowing, drooling, and severe breathing difficulty.
- Children often prefer to sit leaning forward (“tripod position”) to ease breathing.
- Immediate hospital care is required, often including intubation or tracheostomy.
- Routine vaccination with Hib (part of the pentavalent vaccine) prevents most cases.
Causes of Acute Epiglottitis
- Bacterial infection, most commonly Haemophilus influenzae type b (Hib).
- The disease has become rare in Uganda due to routine Hib vaccination.
Symptoms to Watch For
Acute epiglottitis usually develops very quickly. Key signs include:
- High fever
- Severe sore throat and difficulty swallowing
- Drooling, as swallowing becomes painful
- Stridor (a high-pitched noise when breathing in)
- Child may sit leaning forward with mouth open (“tripod or sniffing position”)
- Appears anxious, weak, or drowsy
- Pale or bluish lips/skin (cyanosis)
- Rapid worsening breathing difficulties, which can be fatal if not treated immediately
Important caution: Do not force the child to lie down or examine the throat by pressing the tongue, as this can completely block the airway and lead to sudden death.
How Healthcare Providers Diagnose Acute Epiglottitis
Diagnosis is usually based on clinical signs and urgent evaluation in the hospital. Providers avoid any examination that might upset the child and worsen airway obstruction.
Managing Acute Epiglottitis
Acute epiglottitis is a medical emergency. Management usually involves:
- Immediate hospital admission
- Airway support, often requiring intubation or tracheostomy
- Intravenous fluids to maintain hydration
- IV antibiotics, commonly ceftriaxone (50 mg/kg once daily for 7–10 days)
- Avoid procedures or injections that may agitate the child until the airway is secured
Early treatment is critical to prevent asphyxia and death.
Prevention
- Hib vaccine, given as part of the pentavalent DPT/HepB/Hib vaccination, protects children from most cases of acute epiglottitis.
- Ensure your child completes the full immunisation schedule on time.
FAQ: Common Questions About Acute Epiglottitis
1. How serious is acute epiglottitis?
It is very serious and can be life-threatening. Rapid recognition and urgent hospital care are essential.
2. Can this happen in older children or adults?
It is most common in young children but can occur in unvaccinated older children or adults.
3. How quickly do symptoms appear?
Symptoms can develop within hours, often progressing rapidly to breathing difficulty.
4. What should I do if I suspect epiglottitis?
Call emergency services immediately and do not try to examine the throat or lay the child down.
5. Can epiglottitis be prevented?
Yes, routine Hib vaccination is very effective in preventing the disease.
6. How is it treated in the hospital?
Treatment includes airway management, intravenous fluids, and antibiotics. Quick action can save lives.
7. Is home care safe?
No. Acute epiglottitis is a medical emergency and cannot be treated safely at home.
