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What is Epiglottitis?

  • Epiglottitis is a medical emergency that may result in death if not treated quickly. The epiglottis is a flap of tissue that sits at the base of the tongue that keeps food from going into the trachea (windpipe) during swallowing. When it becomes infected or inflamed, it can swell and obstruct or close off the windpipe, which may be fatal unless promptly treated.
  • Location of the epiglottis.
    Location of the epiglottis. Click to view larger image.

  • Respiratory infection, exposure to environmental chemicals, or trauma may result in inflammation and/or infection of structures around the throat, which may spread to involve the epiglottis. Epiglottitis usually begins as an inflammation and swelling between the base of the tongue and the epiglottis. This may cause the throat structures to push the epiglottis backward.
  • With continued inflammation and swelling of the epiglottis, complete blockage of the airway may occur, leading to suffocation and death. Autopsies of people with epiglottitis have shown distortion of the epiglottis and its associated structures including the formation of abscesses (pockets of infection or pus). For unknown reasons, adults with epiglottic involvement are more likely than children to develop epiglottic abscesses.
  • Epiglottitis was first described in the 18th century and was accurately defined by Le Mierre in 1936. Although George Washington's death in 1796 was attributed to quinsy (abscess), which is a pocket of pus behind the tonsils, it was actually due to epiglottitis.
    • In the past, epiglottitis was more common in children than in adults. This difference was believed to be because of the smaller diameter of the opening to the windpipe when compared to adults.
    • A little narrowing of the windpipe can dramatically increase the resistance of an airway, making breathing much more difficult.
  • A conservative estimate of the incidence of epiglottitis is one case per one hundred thousand people in the United States. In adults, the disease occurs in men three times more frequently than in women.
    • Since 1985, with the widespread vaccination against Haemophilus influenzae type b (or Hib), which was the most common organism related to epiglottitis, the overall incidence of epiglottitis among children has dropped dramatically.
    • Epiglottitis occurs with different age peaks in both children and adults. In children, generally epiglottitis typically peaks in children aged 2-4 years. In adults, the average age of onset is 45 years.
    • Epiglottitis in the very young (younger than one year of age) is unusual.
Medically Reviewed by a Doctor on 5/26/2016
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