Epiglottitis

Diagnosis

First, the medical team ensures that the airway is open and that enough oxygen is getting through. The team monitors breathing and blood oxygen levels.

Oxygen levels that drop too low might need breathing aid.

Tests after breathing is stable

• Throat exam. Using a flexible fiber-optic-lighted tube, a health care provider looks at the throat through the nose to see what's causing the symptoms. A numbing medicine applied to the nose can make the test more comfortable. This might be done in an operating room in case the airway becomes blocked.
• Chest or neck X-ray. They're not needed for a diagnosis, but X-rays might help providers check if you have epiglottitis. With epiglottitis, the X-ray may show what looks like a thumbprint in the neck. This is a sign of an enlarged epiglottis.
• Throat culture and blood tests. Once breathing is stable, a team member wipes the epiglottis with a cotton swab and checks the tissue sample for Hib. Blood cultures can find out whether there's an infection of the blood known as bacteremia. Bacteremia often is present with epiglottitis.

Treatment

Helping a person breathe is the first step in treating epiglottitis. Then treatment focuses on the infection.

Helping with breathing

Making sure that you or your child is breathing well might mean:

• Wearing an oxygen mask. The mask sends oxygen to the lungs.
• Having a breathing tube placed into the windpipe through the nose or mouth, known as intubation. The tube stays in place until the swelling in the throat goes down. This can take many days.
• Putting a needle into the windpipe, known as a needle cricothyroidotomy. In rare cases, a health care provider creates an emergency airway. To get air into the lungs quickly, a provider puts a needle into an area of cartilage in the windpipe, also known as the trachea.

Treating infection

Antibiotics given through a vein treat epiglottitis.

• Broad-spectrum antibiotic. The infection needs quick treatment. So, a health care provider might prescribe a broad-spectrum drug right away, rather than waiting for results of the blood and tissue cultures.
• More-targeted antibiotic. The first medicine may be changed later, depending on what's causing the epiglottitis.

Preparing for your appointment

Epiglottitis is a medical emergency, so you won't have time to prepare for your appointment. The first health care provider you see might be in an emergency room.