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Epiglottitis

Exams and Tests continued...

Even with all of our modern technology, epiglottitis is not easy to diagnose. It is often mistakenly diagnosed as strep throat or croup. Epiglottitis differs from croup by its worsening progress, lack of a barking cough, and a cherry-red swollen epiglottis versus a red nonswollen epiglottis in croup. One way doctors can tell epiglottitis from croup is by taking X-rays of the neck, which can show the swollen epiglottis.

Still, there are other misdiagnoses of epiglottitis. They include diphtheria, peritonsillar abscess, and infectious mononucleosis.

Noninfectious causes have been mistaken as angioedema (swelling of the tissues in the airway), laryngeal inflammation or spasm, laryngeal trauma, cancerous growths, allergic reactions, thyroid gland infection, epiglottic hematoma (trapped blood pocket), hemangioma (abnormal collection of blood vessels), or inhalational injury.

Epiglottitis Treatment: Medical Treatment

Immediate hospitalization is required whenever the diagnosis of epiglottitis is suspected. The person is in danger of sudden and unpredictable closing of the airway. So doctors must establish a secure way for the person to breathe. Antibiotics may be given.

  • Initial treatment of epiglottitis may consist of making the person as comfortable as possible. For instance, an ill child may be placed in a dimly-lit room with the parent holding the child. Then humidified oxygen may be added while the child is closely monitored. If there are no signs of respiratory distress, IV fluids may be helpful. It is important to prevent anxiety, because it may lead to an acute airway obstruction especially in children.
  • People with possible signs of airway obstruction require laryngoscopy in the operating room or intensive care unit with proper staff and airway intervention equipment. In very severe cases, the doctor may need to perform a cricothyrotomy (cutting the neck to insert a breathing tube directly into the windpipe).
  • IV antibiotics may effectively control inflammation and get rid of the infection from the body. Antibiotics are usually prescribed to treat the most common types of bacteria. Blood cultures are usually obtained with the premise that any organism found growing in the blood can be attributed as the cause of the epiglottitis. However, in many cases, blood cultures may fail to yield this information.
  • Corticosteroids and epinephrine have been used in the past. However, many experts now doubt that these medications are helpful in most cases of epiglottitis. 

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