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Overview

Overview

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 vaccine, which prevents 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 of age. 
  • Family and close contacts that have been exposed to a child with epiglottitis will also need to take an antibiotic.

Symptoms & Causes

In-Depth

What is 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.

What causes epiglottitis?

Epiglottitis is a bacterial infection, which is spread through the upper respiratory tract. The bacteria is usually Haemophilus influenzae type B (Hib). No one really knows why some children develop the disease, while others don't.

Is epiglottitis common?

The Hib vaccine, recommended for infants at 2, 4, 6 and 15 to 18 months of age protects against this bacteria, making the condition very rare for infants.

What are the symptoms ofepiglottitis?

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

  • upper respiratory infections
  • 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

Can you prevent epiglottitis?

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

Testing & Diagnosis

Tests

How does a doctor know that it's epiglottitis?

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 immediately be transferred to the hospital.

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

  • x-ray of the neck
  • blood tests
  • visualization of the airway

Treatments

Epiglottitis requires immediate emergency care to prevent your child from stopping breathing. Once your child is being monitored, the airway is safe and antibiotics are started, 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 epiglottitis, your family or other close contacts are usually treated with a medication called Rifampin, to prevent the disease in those people who might have been exposed.

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