By Dr Ananya Mandal, MD
Epiglottitis or infection and inflammation of the epiglottis may affect adults and children alike.
However, the condition is more common in children and is rare among adults with normally functioning immune system.
With the rise of vaccination against Haemophilus influenza type b there is a decline in number of cases worldwide.
Causes of epiglottitis
Causative organisms of epiglottitis include Haemophilus influenzae type b (Hib); group A beta-hemolytic streptococcus and so forth. (1-5)
Haemophilus influenzae type b (Hib)
In children more than 90% cases are caused by Haemophilus influenzae type b (Hib).
After institution of mass vaccination the numbers infected with Hib have reduced.
Hib can cause not only epiglottitis but also pneumonia or lung infection and meningitis or brain fevers.
The Hib bacteria is spread in a similar way to flu viruses. Those with the infection can spread the virus when they cough or sneeze. This happens via the tiny droplets of saliva and mucus that contain the virus that are released in air.
These droplets can also contaminate surfaces and objects. Touching the infected objects and touching the face and mouth with same hands may lead to transmission of infection.
Group A beta-hemolytic streptococcus
Currently, the most common identiﬁed organisms causing epiglottitis in children are group A beta-hemolytic streptococcus, Streptococcus pneumoniae, Klebsiella, Pseudomonas, etc.
In newborns with immature immune systems fungi and yeast like Candida may also cause epiglottitis.
Complication of croup infection
Epiglottitis may result as a complication of croup infection.
Croup is an infection of the larynx (voice box) and trachea (windpipe). This infection may spread to the epiglottis as well. This is common in children.
Cause in adults
In adults the commonest cause of acute epiglottitis are Haemophilus influenzae seen in 25% cases. Haemophilus parainfluenzae, Streptococcus pneumoniae, and group A streptococci are causative organisms in most of the remaining cases.
Causes of epiglottitis that are not infectious
Causes of epiglottitis that are not infectious include injury due to burns of the throat e.g. in bottle fed infants, foreign body ingestion (for example children choking on a bottle cap or other small objects), in people who smoke crack cocaine and marijuana.
Burns can also result from chemicals accidentally ingested or as a result of chemotherapy or radiation therapy over head and neck for cancers.
Injury to the neck may also result in epiglottitis.
Edited by April Cashin-Garbutt, BA Hons (Cantab)
What is epiglottitis?