Epiglottiditis

Description:

The epiglottiditis is an inflammation of an epiglottis and surrounding fabrics which can lead to sharp disturbance of passability of respiratory tracts.

The throat represents a framework from cartilages, muscles and a mucous membrane which create an entrance to a trachea. The epiglottis presents itself a mobile cartilage in the form of a petal which plays a valve role between a trachea and a throat. He prevents hit of food in a trachea. At the time of swallowing the epiglottis closes a gleam in a trachea and food gets into a gullet. Therefore we cannot breathe and swallow at the same time. When we do not eat or we do not drink an epiglottis is slightly raised, opening pass to a trachea. In case of epiglottis hypostasis as a result of an inflammation or an injury the entrance to a trachea is narrowed and can be even closed completely. The epiglottis is one of throat cartilages in the form of a petal which covers an entrance to a trachea.

The acute epiglottiditis occurs generally at children of 2 - 4 years, but both more senior children, and adults are ill it. After introduction in 1985 of immunization against Haemophilus influenzae of type B it meets less often.

At children of early age quickly (in several hours) fever, irritability, a dysphonia, a dysphagy develop. Patients prefer to sit, having bent forward; saliva follows from a mouth. At teenagers and adults less acute beginning at which symptoms (especially a pharyngalgia) accrue during 1-2 days is possible. At 25% of adult patients an asthma, at 15% - hypersalivation, at 10% - a stridor is noted.

Epiglottiditis symptoms:

The epiglottiditis is preceded sometimes by an upper respiratory tract infection. The disease can quickly progress and during 2-5 h completely to block respiratory tracts as a result of an inflammation and flowing off of an epiglottis. Main symptoms of an epiglottiditis:  high temperature, breath, noisy with whistle, the inflamed throat, irritability, concern, exhaustion; the complicated swallowing. To facilitate the state, the child extends a neck, sits down and bends with an open mouth and the put-out language forward; nostrils in attempt to make a breath are inflated.

In case of an inflammation of the epiglottis caused by a bacterium гемофилус to an influenza fever and severe pain in a throat is noted.

Treat other symptoms of an epiglottiditis:
- Hypersalivation.
- Vocal murmur.
- The complicated breath.
- Cyanosis of lips (sign of shortage of oxygen).

Distinguish the edematous, infiltrative and abscessing epiglottiditis forms.
Are characteristic severe pain when swallowing of an edematous form, intoxication, morbidity at a neck palpation, fervescence to 37-39 °C, a bright diffusion hyperemia of a mucous membrane of an epiglottis. Underlying departments of a throat without pathological changes. In blood the leukocytosis, increase in SOE usually is defined.

At the infiltrative and abscessing forms of an acute epiglottiditis the serious general condition of the patient, quickly or slowly developing symptomatology, temperature increase to 38-39 °C, an intolerable pharyngalgia, feeling of shortage of air, painful grimaces is observed. Language is laid over by a dirty-gray plaque, the epiglottis is thickened and hyperemic, the vitreous hypostasis extending to pear-shaped sine and cherpalonadgortanny folds is observed. At the abscessing acute epiglottiditis the pus translucent through an edematous mucous membrane is visible, other departments of a throat are vast. An inspiratory asthma is expressed.

At an acute epiglottiditis along with an exudative component of an inflammation quickly enough develops hondroperikhondrit an epiglottis.

Complications
If to leave an epiglottiditis without treatment, then impassability of respiratory tracts can develop. It in turn will result in shortage of oxygen, a loss of consciousness, spasms and death within several hours. Less than in 10% of cases the epiglottiditis leads to pneumonia (pneumonia), to swelling of lymph nodes on a neck, to a pericardis (an inflammation of a cordial bag) and vypotny pleurisy (accumulation of a zhidokost in a pleural cavity).

Epiglottiditis reasons:

The bacterium гемофилус to an influenza (Haemophilus influenzae), type b is the most frequent reason of an inflammation of an epiglottis. This species of a bacterium also causes pneumonia and meningitis. This microbe can get into airways in the airborne way. Besides, гемофилус to an influenza can "doze" in a nasal cavity until unfavorable conditions are not an incitement for development.

Except the specified bacterium treat activators of an epiglottiditis also:
- Pneumococcus, the most frequent causative agent of meningitis.
- Streptococci of group A, B and C.
- Drozhzhepodobny fungus Candida, milkwoman's activator.
- Varitsella a zoster – the causative agent of chicken pox.

The epiglottiditis can arise owing to a direct injury. Besides, the epiglottiditis arises owing to a burn of respiratory tracts or at the use of very hot liquids.

Other reasons of an inflammation of an epiglottis: throat burn chemicals (acids or alkalis), injury foreign body, smoking of such substances as cocaine or heroin.

In the 20th century the majority of cases of an epiglottiditis occurred at children, especially aged from 2 up to 7 years. However owing to universal immunization of children which began in 1985 the number of cases of an epiglottiditis at children sharply decreased. Now the case of an epiglottiditis occurs at one adult on 100 thousand annually. Children have less.

Throughout all 20th century, the epiglottiditis was a usual disease at children especially aged from 2 up to 7 years and less often at adults. But since that moment as began to do infantile vaccination in 1985, the number of children with an epiglottiditis strongly went down. Today this disease meets once on 100 000 adults and is even more rare at children.

Treat possible risk factors of an epiglottiditis:
- Floor. The epiglottiditis affects more men than women.
- Race. People with dark skin are more subject to infection, than people with white skin. Various opportunities of medical care, including vaccination in the childhood which are not always available in less rich segments of the population.
- Factor of the crowded cities. Bacteria extend quickly when people are in close contact. Infections very quickly extend in kindergartens and a day nursery, but they also extend quickly and at schools, at offices and within households.
- Weak immune system. If your immune system was weakened by a disease or treatment, you are more inclined to perception of viruses and bacteria which can cause an epiglottiditis.

Treatment of the Epiglottiditis:

The epiglottiditis always demands acute management. It is impossible to treat him houses means simple, available to everyone.

The acute management which is carried out in the conditions of intensive care unit consists first of all in introduction under anesthetic to respiratory tracts of the child of a plastic tube to provide free breath. The x-ray film becomes to be convinced that the epiglottis blocks respiratory tracts.
Intravenously to the child enter antibiotics to destroy the bacteria which caused an epiglottiditis. Also in a vein pour in liquids and nutrients that dehydration and exhaustion did not develop. The child is in the room with specially humidified atmosphere to prevent drying of respiratory tracts. Heart failure and breath monitorirutsya.

Stay in hospital is usually limited for 5-7 days, receives antibiotics of the patient within 7-10 days.

Acute management. The inflammation of an epiglottis can become fatal if in time not to give the emergency help. Call the pediatrician or if the matter is urgent, call "ambulance" or immediately carry the child to hospital of acute management. The following has to be a reason for holding such urgent actions: the child wakes up in the afternoon or at night, talks nonsense, tries to sit down or constantly asks on hands, extends a head forward, the mouth its all the time is open, will put out tongue, the child convulsively gasps for air, an asthma accrues; there is a difficulty when swallowing; body temperature rises to 39-40 °C, the child complains of severe pain in a throat. All this symptomatology arises suddenly, collapsing as if snow on the head. As a rule, before no signs of an indisposition at the child happen.

First, calm down and try to calm the child. Quiet parents can make a lot of things to facilitate a condition of the child and to reduce his fear. Never try to press down in this situation language of the sick child from top to bottom, do not try to consider what happens at it in a throat, and do not force the child to change position of the head. Similar actions can instantly cork respiratory tracts of the patient. If you go by the car, open a window and put the child so that he could breathe quietly. Do not include an oven. Quietly repeat to the child: "Breathe slowly and exactly".