Epiglottitis

Epliglottitis is a potentially life-threatening disease that can lead to rapid, unpredictable airway obstruction resulting in hypoxia and respiratory arrest. It is an inflammatory condition, usually infectious, primarily of the epiglottis but often including the aeryepiglottic folds and the loose connective tissue in the pre-epiglottic and paraglottic spaces. Some clinicians prefer the term supraglottitis because the process rarely involves just the epiglottis.

Epiglottitis is traditionally reported to affect children between the ages of 2 and 8 years. 5 Epiglottitis and meningitis are the most common life-threatening diseases caused by Haemophilus influenzae type b (Hib). With the introduction of the Hib vaccine, the incidence of epiglottitis in children has been reduced, while the incidence in adults appears to be increasing.6 Epiglottitis is more common in African Americans than in whites or Hispanics.7 Incidence peaks in the spring and the fall and in during the summer months.8

Epiglottitis can be caused by bacteria, viruses, and fungi (Table235:2), but the commonest cause is Hib.9!0 Other pathogens that have been isolated include Streptococcus species, Staphylococcus species, Moraxella catarrhalis, Klebsiella, Mycobacterium tuberculosis, Candida species, respiratory syncytial virus, varicella virus, adenovirus, and herpesvirus.

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