Epiglottitis

Definition

Epiglottitis is a life-threatening inflammation of the epiglottis and surrounding supraglottic structures, usually caused by bacterial infection, leading to acute upper airway obstruction in children.

Epidemiology

• Peak incidence in children aged 2–7 years
• Incidence has declined significantly due to Hib (Haemophilus influenzae type b) vaccination
• More common in boys than girls
• Rapid onset and progression make it a pediatric emergency
• Rare in neonates and adults, but more severe if occurs

Etiology

• Bacterial infection (most commonly Haemophilus influenzae type b)
• Other pathogens: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus
• Trauma or thermal injury to the epiglottis (rare)
• Immunocompromised children at higher risk
• Post-upper respiratory infection or coexisting viral infection may predispose

Pathophysiology

• Bacterial invasion causes inflammation and edema of the epiglottis and supraglottic structures
• Swelling narrows the airway, causing turbulent airflow and stridor
• Rapid progression can lead to complete airway obstruction
• Local inflammation triggers systemic symptoms: fever, tachycardia, and malaise
• Hypoxia and respiratory acidosis may develop quickly in severe cases
• Secondary infection or sepsis may occur if untreated