Symptoms and Signs of Epiglottitis

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 8/6/2021

Doctor's Notes on Epiglottitis

Epiglottitis is a medical emergency that can be fatal 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 the epiglottis becomes inflamed or infected, it can swell and block or close off the windpipe, blocking the flow of air into the lungs, which may result in suffocation and death if not treated promptly.

Symptoms of epiglottitis often occur quickly and include

  • sore throat,
  • muffling or changes in the voice,
  • difficulty speaking,
  • fever,
  • difficulty swallowing,
  • painful swallowing,
  • fast heart rate,
  • difficulty breathing,
  • drooling,
  • leaning forward to breathe,
  • taking rapid shallow breaths,
  • "pulling in" of muscles in the neck or between the ribs with breathing (retractions),
  • high-pitched whistling sound when breathing (stridor),
  • noisy breathing,
  • difficulty catching your breath, and
  • raspy voice.

In children, symptoms of epiglottitis are similar to those in adults and may also include irritability, refusing to eat, anxiety or restlessness, and less commonly cough, and ear pain.

What is the Treatment for Epiglottitis?

Epiglottitis is a medical emergency. Immediate treatment to keep the airway from closing is important and includes:

  • Antibiotics such as cephalosporins, clindamycin, and vancomycin to fight infections
  • Steroid medications such as dexamethasone and solumedrol to decrease inflammation
  • Oxygen therapy to keep oxygen levels up in the body
  • Inhaled epinephrine to decrease the size of the swollen epiglottis
  • Intubation (a tube placed in the trachea) to secure the airway before it closes off
  • Cricothyrotomy (a hole surgically placed in the neck) if intubation attempts are not successful

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.