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    Epiglottitis

    Prevention

    Epiglottitis can often be prevented with proper vaccination against H influenza type b (Hib). Adult vaccination is not routinely recommended, except for people with immune problems such as sickle cell anemia, splenectomy (removal of the spleen), cancers, or other diseases affecting the immune system.

    If there is a house with a Hib-infected person, preventive medication such as rifampin (Rifadin) should be given to anyone else in the house who is:

    • Under age 4 years and has not received all the Hib vaccinations
    • Under 12 months and has not finished the first series of Hib vaccine
    • Under age 18 with a weakened immune system

    This is to make sure that both the person with the illness and the rest of the household have the bacteria completely eradicated from their bodies. This prevents formation of a "carrier state" in which a person has the bacteria in the body but is not actively sick. Carriers can still spread the infection to other family members.

    Next Steps: Follow-up

    Follow-up involves continuing to take all antibiotics until the full course is completed, keeping all follow-up appointments with the doctor and with the surgeon if a breathing tube had to be placed through the neck. The surgeon will remove the tube and make sure the site is healing well. Most people improve significantly before leaving the hospital, so taking the antibiotics and returning to the hospital if there are any problems are the most important parts of follow-up.

    Outlook

    A person with epiglottitis can recover very well with a good prognosis if the condition is caught early and treated in time. In fact, a good majority of people with epiglottitis do well and recover without problems. But if the person was not brought to the hospital early and was not appropriately diagnosed and treated, the prognosis may range from long-range illness to death.

    • Before 1973, about 32% of adults with epiglottitis died from the disease. With current vaccination programs along with earlier recognition and treatment, the overall death rate from epiglottitis is estimated to be less than 1%. The death rate from epiglottitis in adults is higher than that of children because the condition can be misdiagnosed.
    • Epiglottitis can also occur with other infections in adults, such as pneumonia. Most commonly, it is misdiagnosed as a strep throat. However, if it is caught early and treated appropriately, a person can expect to fully recover. Most of the deaths come from failure to diagnose it in a timely fashion and obstruction of the airway. As with any serious infection, bacteria may enter the blood, a condition called bacteremia, which may result in infections in other systems and sepsis (severe infection with shock, often with respiratory failure).

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