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Friday, September 10, 2010
 
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Epiglottitis(P)
 
  • The epiglottis is the cartilaginous structure hanging over the entrance to the larynx and covering the vocal cords.  Its function is to keep food from passing into the larynx and trachea (i.e., the airway bringing air to the lungs).  When the epiglottis becomes inflamed or infected, this condition is known as epiglottitis.
  • It usually occurs in children between 2 and 7 years of age.
 
  • Pain on swallowing
  • Sore throat
  • Difficulty or garbled speech
  • Drooling
  • Shortness of breath
  • Fever
  • Exhaustion
  • Hoarseness
  • Brassy cough
  • Irritability, restlessness
  • Pallor
  • Bluish lips and skin
  • Change in consciousness
  • Open mouth
  • Head forward
 
  • Haemophilus Influenza
  • Haemophilus paraInfluenza
  • Streptococcus pneumoniae
  • Group A streptococcus
  • Staphylococcus aureus
 
  • Stridor -- a whistling sound heard in the neck with a stethoscope
  • Abnormal finding in the lateral neck X-ray (normal in 20% of cases of epiglottitis)
  • Indirect laryngoscopy (not safe to do in children) shows a swollen, red epiglottis
  • Children should be taken to the doctor to have the epiglottis viewed with a special type of scope (flexible fiber optic laryngoscope).  If they have this condition, they are placed on a ventilator because they are at high risk of having the airway close off.
 
  • Keep the child upright.
  • Intravenous antibiotics such as cefotaxime, cefriaxone, or ampicillin with sulbactam
  • Administer oxygen and monitor oxygenation
  • Intubation (place on ventilation machine) if airway is in danger of closing (see above).
This is a life-threatening emergency.  This condition can cut off your child's airway and result in suffocation.  The patient needs emergency medical treatment -- call 911 immediately.
  • Croup
  • Whooping Cough
  • Peritonsillar Abscess
  • Strep throat
  •  
    • The most common cause is Haemophilus Influenza.  A vaccine is now available and given to all children as part of their routine vaccinations.
    • Rifampin prophylaxis for appropriate family members/contacts

     


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