Воспаление надгортанника: причины, симптомы и лечение

Inflammation of the epiglottis

Adults commonly present with less dramatic breathing symptoms than children due to them having wider airways to begin with, so their main symptoms are usually a severe sore throat and difficulty swallowing.

Epiglottitis is primarily caused by an acquired bacterial infection of the epiglottis. Presently, the bacteria most often causing infection are other encapsulated organisms including Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus. While the overall incidence of epiglottitis has decreased, the incidence of cases caused by Streptococcus pneumoniae has increased in adults. The exact strains of Streptococcus pneumoniae are often those that are covered by the PPV 23 vaccine, While a variety of different bacteria can cause disease in these patients, cases often involve the Candida species of fungus, though it is unknown if the fungus causes significant disease on its own. Underlying disorders of the immune system, such as graft versus host disease and lymphoproliferative disorders, have also been identified as contributors of increased risk for developing the infection .

On lateral C spine X ray, the thumbprint sign describes a swollen, enlarged epiglottis.

An effective vaccine, the Hib vaccine, has been available since the 1980s. Currently, the CDC recommends that children receive a two or three dose primary series with an additional booster dose. The countries of the world who have included the Hib vaccine in their immunization schedules typically begin the series at the age of two or three months with subsequent doses administered at four or eight week intervals. Routine vaccination in these nations has led to a dramatic decrease in the incidence of invasive diseases caused by H. influenzae type b such as epiglottitis, meningitis and pneumonia.

The most important part of treatment involves securing the airway. If S. aureus is suspected to be causing the disease, then the treatment should include ceftaroline or clindamycin as these would provide coverage against antibiotic resistant strains of that bacteria (MRSA). Between 1998 and 2006, there were an average of 36 deaths per year in the United States attributed to epiglottitis, giving a case fatality rate of 0.89% during that time period. A 2010 retrospective study revealed the average age of patients admitted to American hospitals for epiglottitis was about 45, but patients under the age of 1 and over the age of 85 are also particularly vulnerable.

Bill Bixby's 6 year old son Christopher died of the condition in 1981. Jeannie Mai spent some time in an ICU with epiglottitis. Sarah Silverman spent a week in the ICU at Cedars Sinai Hospital with epiglottitis. George Washington is thought to have died of epiglottitis. The treatments given to Washington, such as severe bloodletting, an enema, vinegar, sage, molasses, butter, blistering his throat with Spanish fly, requiring him to swallow mercurous chloride and antimony potassium tartrate, and applying wheat poultices to various parts of the body, are no longer used. Jin announced in a 2022 video that he had been diagnosed with epiglottitis. Wes Moore's father died of epiglottitis when Moore was four years old.