Exams and Tests

• The doctor may perform x-rays or simply look at the epiglottis and the windpipe by laryngoscopy-a procedure performed in an operating room.
  
  
  • The doctor may find that the pharynx is usually inflamed with a beefy cherry red, stiff, and swollen epiglottis.
    
    
  • Make no attempt at home to inspect the throat of a person suspected of having epiglottitis.
    
    
  • Because manipulation of the epiglottis may result in sudden fatal airway obstruction and because irregular slow heart rates have occurred with attempts at intubation (putting a tube down the throat and placing the person on a machine that helps with breathing), the doctor will use the controlled environment of an operating room to see the throat structures.
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• Other laboratory tests that doctors use to screen illnesses may include the following:
  
  
  • Blood tests to look for infection or inflammation
    
    
  • Arterial blood gas, which measures oxygenation of the blood
    
    
  • Blood cultures, which may grow bacteria and indicate the cause of the epiglottitis
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  • Other immunologic tests looking for antibodies to specific bacteria or viruses
  
  
• These laboratory tests may not be useful in diagnosing epiglottitis until the person is stable. Also, the anxiety from having blood drawn or cultures taken from the throat may cause the unstable epiglottis to close off, completely obstructing the airway and creating an emergency with only a few minutes to correct.
  
  
• Even with all of our modern technology, epiglottitis is not easy to diagnose. An interesting fact is that studies have reported that epiglottitis has been initially misdiagnosed in 36-50% of people. The most common misdiagnosis of epiglottitis is mistaking it as strep throat.
  
  
  • Other possible diagnoses include infectious causes such as croup, diphtheria, peritonsillar abscess, and infectious mononucleosis.
    
    
  • Noninfectious causes have been mistaken as angioneurotic edema (swelling of the tissues in the airway), laryngeal inflammation or spasm, laryngeal trauma, cancerous growths, allergic reactions, thyroid gland infection, epiglottic hematoma, hemangioma, or inhalational injury.
    
    
  • It is often easy to mistake epiglottitis for croup. Epiglottitis differs clinically 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 x-rays of the neck.