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When Your Child Has Epiglottitis

Epiglottitis is a medical emergency. It’s an infection of the epiglottis. This is the small flap of tissue at the back of the throat. It stops food and liquids from entering the windpipe (trachea) when a person eats or drinks. The rest of the time, it lifts so air can flow easily into and out of the lungs. Epiglottitis causes swelling that may close off the airway and make it hard to breathe. This condition requires medical care right away. If not treated quickly, it can be fatal.

What causes epiglottitis?

Most often, epiglottitis results from infection with Haemophilus influenzae type b (Hib) bacteria. The bacteria spread through the air in tiny droplets when an infected person coughs or sneezes. The infection starts with a high fever and sore throat. Breathing problems can come on quickly. Now that there is an Hib vaccine, this infection is very rare. Talk with your child's healthcare provider about the Hib vaccination.

Epiglottitis is an emergency!

Call 911

Epiglottitis can be deadly if not treated quickly. If your child has any of the symptoms below, call 911right away:

  • Trouble swallowing, breathing, and talking

  • Straining the neck forward (trying to open the airway)

  • Drooling (when it becomes too painful to swallow)

  • A harsh raspy sound when inhaling (stridor), a sign that the airways are blocked

  • Blue, purple, or gray skin or lips

  • Trouble waking up to awake or arouse or unresponsive

  • Trouble breathing

When the above symptoms occur:

  • Don’t try to check your child’s throat yourself. You may make matters worse.

  • Don’t give your child food, water, or cough medicines. These may cause vomiting and make it even harder to breathe.

  • Don’t encourage your child to lie down. They will likely be the most comfortable leaning forward in a sitting position.

How is epiglottitis treated?

  • To allow air into the lungs, doctors may place a breathing tube into the windpipe. The tube is passed through your child’s nose or mouth. It provides an airway around the swelling, letting air flow freely into and out of the lungs. The breathing tube must stay in place until the swelling in the throat has gone down.

  • In the most serious cases, doctors may create an emergency airway into the windpipe directly through a hole in the neck.

  • Once your child is breathing more easily, certain tests may also be done. These may include X-rays, blood tests, and a throat culture. This is a test that looks for bacteria in a sample of material from the throat.

  • Antibiotics and fluids will be given through an IV (intravenous) line.

  • Your child’s breathing will be watched closely.

What are long-term concerns?

With treatment, most children get better with no lasting effects.

The Hib vaccine

Vaccination with the Hib vaccine is the best way to prevent epiglottitis. Other germs can lead to epiglottitis. But Hib bacteria are the most common cause. Children often get the vaccine at:

  • 2 months

  • 4 months

  • 6 months (if needed, depending on the brand of vaccine)

  • 12 to 15 months

Side view of child leaning over with mouth open. Throat anatomy shows epiglottitis.
Craning the neck forward in order to breathe can be a sign of epiglottitis.

Side view of child's head showing throat anatomy with inflamed epiglottis.
An inflamed epiglottis blocks the airway.

Online Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 1/1/2020
© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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