Epiglottis syndrome treatment with folk remedies

Epiglottis: concept, functions, diseases

Each person, to a greater or lesser extent, is interested in and cares about his own health - he tries to lead a correct lifestyle, and when the first symptoms appear, signaling problems and malfunctions in the body, he seeks medical help from a specialist.
Most often, a patient comes to visit an ENT doctor in cases of viral diseases, influenza, or complicated tonsillitis. At the same time, there are a lot of pathologies of ENT organs (both in children and adults), the main symptoms of which are extremely important to know - this will help to diagnose the disease in a timely manner and prescribe treatment.

Symptoms of inflammation of the epiglottis at different stages

Diagnosis consists, first of all, of performing a series of studies. These include tests such as laryngoscopy, which relies on direct inspection through the insertion of a thin tube into the patient's larynx. Other tests include blood culture or throat secretion. An important test is also a general blood test or an X-ray of the neck, which can help diagnose a tumor.

Among the effective home remedies are compresses on the neck, which need to be changed several times during the day, gargling and inhalation. Chronic inflammation of the epiglottis requires long and tedious treatment. It consists, first of all, in removing harmful factors that contribute to the development of the disease.

The specialist in this case is a laryngologist, who most often uses a very weak solution of silver nitrate. Drug treatment is also prescribed. It is also advisable to drink drinks, such as hot tea with lemon. Antibiotic therapy is very often used.

Effective protection against bacterial inflammation of the epiglottis is vaccinations. Vaccination against Hib infection is recommended for all children. You can also choose an associated vaccine, which protects against more than five diseases at once. Unfortunately, inflammation of the epiglottis cannot be prevented.

Despite this, you should limit the risk of infection in your child and dress him warmly, especially in cloudy weather. It is necessary to supply the body with the necessary amount of vitamins and minerals that strengthen the immune system. Adults should use their voices wisely and take care of their health.

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Nasal congestion, runny nose. Read about treating a runny nose with a nebulizer here. General malaise. Temperature increase.

Pain, inflammation and redness of the throat. Fever. Difficulty swallowing. Breathing is heavy, accompanied by whistling and the participation of auxiliary muscles. The patient becomes irritable, feels fear and anxiety.

At this stage, it is very important to call an ambulance and clearly explain all the symptoms to the doctors during the call.

The neck is extended, the mouth is open, the tongue sticks out. The sound of the voice is suddenly muffled. When you inhale, the wings of your nose swell noticeably. Increased salivation begins.

Edema is accompanied by severe pain when swallowing, pain on palpation of the neck, intoxication and a temperature of 37-39 ° C. The abscessive and infiltrative form of acute inflammation of the epiglottis is accompanied by an increase in temperature to 38-39 ° C, a severe general condition of the patient, and severe sore throat.

An experienced doctor will definitely recognize epiglotitis by the external manifestations and well-being of the patient. It is very difficult to examine a child’s throat in this condition.

To make a diagnosis and determine the degree of swelling, it is necessary to take an x-ray of the throat. A blood test and oropharyngeal culture will help determine the causative agent to determine the causative agent for antibiotics. Another method that is used to diagnose the disease and provide emergency care to the patient is to examine the epiglottis using a special flexible fiberscope in the operating room using tracheal intubation methods.

The development of a dangerous disease can be prevented if the causes and provoking factors that lead to the occurrence of pathology are eliminated. Thus, it is necessary to protect the child from tobacco smoke and contact with toxic volatile chemical compounds.

It is important to monitor the temperature of the food and drinks your baby consumes (food or drink that is too hot can lead to burns and inflammation). It is especially important to regularly strengthen the baby’s immunity, since a healthy immune system actively resists pathogenic bacteria that cause epiglottitis.

Epiglottitis is a rather rare, but no less dangerous disease that negatively affects the baby’s health and can lead to his death.

When the first characteristic symptoms appear, such as a sharp sore throat, signs of suffocation, it is necessary to call an ambulance as soon as possible.

At the same time, even before the doctors arrive, it is important to provide first aid to the child. It is important to clearly understand your plan of action and not make mistakes that could be fatal for the baby. And for this you need to remain calm and not give in to panic.

Causes of epiglottitis

Rapidly developing swelling of the epiglottis can lead to complete blockage of air flow. The inflammation is caused primarily by the bacterium Haemophilus influenzae. It may also be other bacteria that cause upper respiratory tract infections: Streptococcus pneumoniae or Streptococcus pyogenes. Often, infection is facilitated by damage to the mucous membrane by spicy food, which facilitates the penetration of bacteria.

See the epiglottis...

Symptoms of inflammation of the epiglottis appear mainly at night. The first symptoms are usually a low fever and a sore throat.

Other symptoms: difficulty breathing, most often the child takes a sitting position, leaning forward, mouth open, saliva flowing. Hoarseness, slurred speech, and wheezing occur.

Cyanosis and chills often also appear. If such symptoms occur, the patient should see a doctor as soon as possible.

Epiglottis - concept and functional purpose ↑

In medical terminology, this organ is understood as movable cartilage, which acts as an adapter connecting the pharynx to the trachea and preventing the penetration of food particles and foreign bodies into it.

At the moment of swallowing food, the epiglottis closes the tracheal tract, while at rest it is slightly open, and the cartilage is slightly raised - this ensures air flow. In case of infectious lesions of the organ, its multiple increase is observed due to extensive swelling of the tissue. The result is difficulty breathing. For a person experiencing similar symptoms, everything can end quite sadly if medical assistance is not provided on time.

If you compare a dissected photo of a cartilaginous valve in a normal state with an analogue in a state of inflammation, then this defect will be clearly visible in the image.

Infectious microorganisms that affect an organ are very insidious, fraught with complications, and in every third case, “acquaintance” with them is fatal if the disease is not diagnosed on time.

The epiglottis is an unpaired component of the larynx, which, if necessary, blocks access to it, thereby ensuring its uninterrupted activity. This is the main functional purpose of the component.

When studying the structure of the epiglottis in an adult patient and a child using photographs, three layers should be distinguished, arranged in the following sequence:

• mucosa - the outer surface layer, consists of a covering - epithelium and plate. The activity of the mucosa is supported by a rather sharply occurring variant of cartilaginous tissue - elastic skeletal-forming tissue;
• the superficial layer of epithelium on the oral cavity and a large area of ​​the larynx. The composition of the surface is flat, multi-level, not prone to keratinization and death of tissue particles. Its movement to the next row - the ciliated epithelial one - is a somewhat uneven line (the transition threshold is clearly visible when magnified in the pictures). The depth of the transition is individual; its size may vary depending on the structural features of the body, the age of the adult or child, and the state of health of the larynx;
• own plate of mucous soft tissue - is a loose, soft layer that performs a connective function and envelops the salivary glands, the circulatory system, lymph nodes and vessels, as well as nerve endings and tissue fibers. Located in cartilaginous recesses, the glands often undergo perforation, creating a precedent for the formation of several components in one section.

Efficacy of hib vaccine in preventing disease

Until 1985, when widespread immunization of infants with the ACT-Hib or Pentaxim vaccine began, epiglotitis was one of the most common diseases in children from 2 to 7 years old. Mortality due to complications and delayed medical care was very high.

Popular TV presenter Elena Malysheva talks about epiglottitis in the next video.

After the introduction of vaccination, the disease develops inflammation of the epiglottis in one in 100,000 adults. In children, the disease is much less common.

Epiglottitis is an inflammatory process localized in the epiglottis and surrounding tissues. The epiglottis plays an important role in the body by preventing food from entering the trachea. It blocks the organ when food is swallowed, so a person cannot inhale and swallow at the same time. If an infection enters the body or is injured, symptoms of inflammation of the epiglottis may appear, resulting in swelling and a decrease in the passage into the trachea. In especially severe situations, the enlarged epiglottis can completely block the passage to the trachea, which can cause a sharp obstruction of the airway and even suffocation.

Inflammation of the epiglottis most often occurs in young children in the first years of life (two to four years), but this does not exclude the possibility of the disease occurring at an older age and even in adults.

Ingestion of the bacterium Hemophilus influenza (hemophilus influenza infection) is the most common cause of acute epiglottitis. Bacteria enter the body through airborne droplets, and if immunity is not reduced, the development of inflammation may not occur immediately. The infection often remains in a latent state until favorable conditions arise. This type of pathogenic microorganisms can also cause other serious diseases (meningitis, pneumonia), which are dangerous due to their complications.

Also among the reasons that can cause inflammation are:

Along with infections, there are other causes that can provoke epiglottitis:

The development of the disease is characterized by rupture of capillaries, which is accompanied by the appearance of small hemorrhages. The tissues of the epiglottis are damaged and a bacterial infection penetrates into the submucosal layers, which causes inflammation and swelling. Depending on the degree of development of the inflammatory process, various stages of the disease are distinguished.

At an early stage, epiglottitis is accompanied by symptoms characteristic of the common cold:

Further development of the disease occurs very quickly. A couple of hours after the first signs of the disease appear, symptoms characteristic of inflammation of the epiglottis may appear:

In this case, the infection often affects not only the epiglottis, but can also cause inflammation in other parts of the nasopharynx.

Important! To prevent the development of epiglottitis, vaccination is recommended for children in the first months of life (Hib vaccine against Haemophilus influenzae infection). If the patient is not provided with timely medical care, the disease may progress to a later stage, which is characterized by:

If the patient is not provided with timely medical care, the disease may progress to a later stage, which is characterized by:

Depending on the nature of the infection, three forms of inflammation are distinguished:

Cyst is the most common disease ↑

Despite the high level of development of modern science, doctors are still unable to determine the true cause that provokes the development of the disease, which occurs in both adult patients and children. The main version is that the organ is clogged with mucus and small microparticles of debris.

Important point! A cyst can be an acquired disease that affects a person, or it can accompany a child from the moment of birth and be transmitted at the genetic level. In the latter case, a throat cyst in children affects the body even at the stage of embryo formation.

The disease is classified as follows:

• retention cyst is the most common case caused by blockage of the larynx. Such a cyst has its own symptoms, its structure is thin, its consistency is watery;
• Dermoid cyst - externally the structure is dense, internally it is viscous. It is extremely rare for a child to be diagnosed;
• secondary cyst - as a consequence of a previous benign formation. Symptoms do not manifest themselves for a long time, and only when a general deterioration in health occurs is a person diagnosed with pathology;
• empty – larintzgole cyst. It is an empty formation inside. When detected early, it responds well to treatment.

Symptoms

Each condition for which a person consults a doctor has its own symptoms. And their identification becomes an important aspect of diagnosis at the primary stage. First, an anamnesis is collected, especially complaints. They are detailed and compared with known pathology. Then the pharynx and larynx are examined (including the use of mirrors) in order to establish objective signs or confirm their absence.

Constitutional features

It’s probably not worth saying that the child’s body continues to grow. The soft tissues are very pliable, the cartilage is elastic, and in some places the bones have not yet reached the highest mineralization. There are various options for individual development and anatomical features that are considered normal. This happens with the larynx, but not only in children.

Even adults can open their mouths in different ways: some are wider, sticking out their tongue well, and some cannot do this for various physiological reasons: the structure and installation of the larynx, muscle tension, etc. But even in them, the epiglottis can be visible when examined with pronunciation of high sounds (“i” or “e”). In this case, the uvula with the soft palate is pulled up, and the cartilage approaches the root of the tongue, as a result of which its apex becomes visible.

Anesthesiologists even have their own classification of the laryngoscopic picture when opening the mouth, which is used to assess the ease of intubation. It is based on the individual structural features of the organ. If you look at it, it will become clear that seeing cartilage when examining the pharynx is the perfect norm:

• 1st degree – the entrance to the larynx is completely visualized.
• Grade 2 – only part of the glottis is visible.
• Grade 3 – only the epiglottis is identified.
• Grade 4 – the epiglottis is not visible.

Each person's larynx is structured differently. And the epiglottis may well appear behind the tongue when opening the mouth under normal conditions. It will be of normal shape and size, with unchanged mucous membrane and without foreign inclusions. Even if the child recently suffered from some kind of respiratory infection, and the mother, after looking at the throat, noticed cartilage, this does not mean the presence of epiglottis pathology.

The pharynx and larynx in a child and an adult have different constitutional features, in which leaf-shaped cartilage is shown during examination of the pharynx.

Lump in the throat syndrome

As people age, the anatomy of the larynx also changes. The epiglottis is slightly deformed, bending forward. At the same time, it becomes visible in an adult. And if there is also a concomitant enlargement of the lingual tonsil located at the root, then its contact with the surface of the cartilage may be observed. This is why many people complain of a feeling of a “lump” or foreign body in the throat.

The “empty throat” movements only increase the mechanical friction of the cartilaginous lobe against the root of the tongue, which can even lead to dislocation of the epiglottis and suffocation. But taking water or food does not increase the discomfort. And during the examination, the ENT doctor does not reveal any deviations from the norm.

Epiglottitis

A completely different situation arises when the mucous membrane of the epiglottis becomes inflamed. The most common causes of pathology are microbes: Haemophilus influenzae and pneumococcus. But the damage sometimes has a different nature, occurring after direct trauma, burns from hot food or aggressive chemicals. The most common symptoms of epiglottitis are:

• Sore throat that gets worse when swallowing.
• Difficulty breathing (wheezing).
• Muffled (nasal) voice.
• Fever.

Quite often, children become irritable and restless, they can take a forced position to facilitate breathing: they stretch their necks forward, sit with their mouths open, leaning forward. If the epiglottis is not visible upon direct examination, then after pressing on the tongue or using a mirror, it becomes clear that it is changed: swollen, reddened and enlarged in size. The wall of the pharynx is also hyperemic, sometimes granular, and accumulations of mucus can be seen on it.

Epiglottitis can develop into a more severe form - an abscess of the epiglottis. Then the general condition worsens even more, shortness of breath is expressed. Adjacent tissues swell, and pus is detected in the cartilage itself, which shines through the thin mucous membrane.

Epiglottis cyst

Most laryngeal cysts are located precisely on the cartilage covering the entrance to it. Most often they are retentional in nature, formed when the excretory ducts of the glands are blocked. But there are also embryonic cysts (dermoid) that form in utero. Therefore, if the epiglottis is visible in a child, it is necessary to determine whether there is a pathological formation on it.

For a long time the cyst is asymptomatic. And only when they reach a certain size do they cause discomfort in the throat, coughing, difficulty breathing or swallowing. Therefore, despite its histological benignity, an epiglottic cyst should be detected in time.

Cystic formations in the epiglottis are not such a common pathology. But they can lead not only to an increase in the size of cartilage, but also cause disruption of vital functions.

What is epiglottic cartilage?

The epiglottic cartilage is a thin plate whose shape resembles a leaf or flower petal. The wide part is localized above the thyroid cartilage, and the narrow part is attached to its inner corner. Elastic cartilage is located in the tracheal tube area, below the lingual root. It has 2 muscles - the scoop, the thyroepiglottic muscle. When they contract, the swallowing reflex is triggered, the epiglottis lowers, closing the mouth with the trachea so that food passes through the esophagus. This is the main task of the epiglottic cartilage. On the surface of the epiglottis there are pits containing mucous glands. They are connected by nerves to the epithelium of the throat, the lingual root, capillaries, and the lower laryngeal nerve.

The epiglottic cartilage consists of 3 layers responsible for a number of functions. These include:

• the mucous membrane reduces friction of the cartilage with other organs and foreign objects;
• mucosal epithelium - part of the membrane responsible for purifying oxygen;
• lamina mucosa - tissue containing nerves, laryngeal glands, blood capillaries, provides the swallowing reflex.

There are individual features of the location of the organ that are found in some individuals. The sheet of the anterior part of the epiglottis folds in half, blocks the road to the pharynx, and complicates examination by indirect laryngoscopy.

Additional diagnostics

During a clinical examination, extreme caution must be exercised, because even simple pressure with a spatula on the root of the tongue can provoke reflex laryngospasm. Therefore, all manipulations must be carried out in a hospital where there is an intensive care unit.

It is better, of course, to use instrumental methods - fibrolaryngoscopy is much more informative and safer. The study will indicate enlargement and hyperemia of the epiglottis, swelling of the arytenoid cartilages and ligaments going to them. An abscess is defined as a yellow spot that appears through the mucous membrane.

X-rays also provide some information. The image shows an enlarged epiglottis (thumb sign). But its absence does not mean that there is no epiglottitis. To identify the causative agent of the infection, smears are made from the hypopharynx with their further bacteriological study (culture, sensitivity to antibiotics). A blood test will also indicate the nature of the process.

It is necessary to differentiate epiglottitis in children with false croup (stenosing laryngotracheitis), foreign bodies, retropharyngeal abscess, stridor, whooping cough and other conditions in which similar symptoms may be observed (primarily difficulty breathing). The clinical picture in combination with additional examination data will allow the doctor to make the only correct diagnosis.

What problems are possible?

The recess of the epiglottic cartilage can be subject to inflammatory processes, the causes of which include Hemophilus influenzae, an infection that affects the oropharynx. It enters the body through the nose and mouth, which act as open gates for air. Other predisposing circumstances can also cause an inflammatory process:

• laryngeal injuries due to blows;
• burns after ingesting hot liquids or food;
• exposure to smoking and alcoholic beverages.

With inflammatory foci, the epiglottic cartilage increases in size, its functioning is disrupted, which prevents the respiratory system from carrying oxygen to the lungs. Bacterial elements affect the organs of the respiratory tract and inhibit the immune antigens of the oral area. As a result, inflammatory processes occur. As they grow, the organ changes shape. Then stenosis of the respiratory tract is possible, which causes the death of a person.

At risk are:

• persons susceptible to allergies;
• infants from 3 to 5 years old - due to weak protective functions, they are at risk of infection;
• people who have had surgery on the spleen;
• men;
• persons suffering from malfunctions of the immune system.

The epiglottis also undergoes age-related changes that appear after 30 years. The cartilage becomes deformed, it sinks, and breathing becomes difficult. This occurs in 20% of the population.

Typical diseases

Epiglottitis is common. The disease is provoked by Haemophilus influenzae and has a severe form. The pathology is extremely dangerous due to its sudden onset of symptoms, which include difficulty in inhaling and exhaling, which can lead to respiratory arrest and death. If therapeutic actions are started on time, the inflammation can be cured without problems. In case of complications, the disease is divided into several stages, depending on the symptomatic features. Epiglottitis is divided into edematous, abscessive, and infiltrative forms.

Epiglottis syndrome is caused by a sensation of a lump in the throat and difficulty breathing. It is important to try to make less swallowing movements so as not to irritate the cartilage when it is raised. If the pain intensifies, contact your doctor for an X-ray diagnosis. Manipulation helps to identify the presence of formation and establish a diagnosis.

Epiglottitis: treatment of the disease

Epiglottitis is an acute inflammatory disease of the epiglottis and adjacent structures that can lead to life-threatening airway obstruction.

In the case of the infectious nature of the disease, inflammation occurs as a result of bacteremia and/or direct invasion of the microorganism into the mucous membrane of the epiglottis.

As a result of swelling and accumulation of inflammatory cells between the epithelial layer and the cartilage of the epiglottis, the latter increases in size. The swelling rapidly progresses and covers the entire vestibule of the larynx (the area of ​​the larynx below the folds is usually not affected), the airways narrow down to complete obstruction, leading to cardiac arrest and death.

Prevalence

The incidence of epiglottitis decreased sharply after the introduction of the Hib vaccine into the routine childhood immunization program. Before the vaccine was available, the incidence was approximately 5 per 100,000 children under 5 years of age. Among immunized children, the incidence of epiglottitis ranges from 0.6 to 0.8 cases per 100,000. The average age of children with epiglottitis has increased from 3 to 6–12 years.

The incidence of epiglottitis in adults has been largely stable over the past few decades, ranging from 0.6 to 1.9 cases per 100,000 people annually.

Risk factors

In children, risk factors include incomplete immunization against Hib and immunodeficiency states.

In adults - arterial hypertension, diabetes mellitus, immunodeficiency states.

Symptoms

Clinical features of epiglottitis vary depending on the etiology, age, and severity of the disease.

In young children, respiratory distress syndrome is usually diagnosed - a progressive respiratory disorder, manifested by shortness of breath, chest depression during inspiration, cyanosis, pallor of the skin, and wheezing when breathing. To facilitate breathing, the child takes a sitting position with the body tilted forward, the neck is extended, the chin is pushed forward. Drooling may occur.

In older children, adolescents and adults, epiglottitis is more often manifested by a sore throat and drooling. During pharyngoscopy (examination of the pharynx), there is often no hyperemia and swelling - the oropharynx looks healthy.

Epiglottitis in children is characterized by a sharp onset and rapid progression of the disease. As a rule, 12-24 hours pass from the moment of the first signs to hospitalization.

The main symptoms of the disease in children:

• difficulty breathing (80%);
• stridor - noisy, wheezing breathing (80%);
• muffled voice or hoarseness (79%);
• pharyngitis (73%);
• fever (57%);
• sore throat (50%);
• sensitivity of the anterior surface of the neck (38%);
• cough (30%);
• difficulty swallowing (26%);
• voice change (20%).

The main symptoms of the disease in adults:

• sore throat (90-100%);
• fever ≥37.5°C (26-90%);
• muffled voice (50-80%);
• drooling (15-65%);
• stridor (33%);
• hoarseness (20-40%).

Survey

In adolescents and adults, laryngoscopy (examination of the larynx) and fibrolaryngoscopy (examination of the larynx with a flexible endoscope inserted through the nasal cavity) are the generally accepted standard for diagnosing epiglottitis.

In children, the diagnostic method depends on the age and severity of the disease. Laryngoscopy is not always possible or safe, so the diagnosis is often made based on the clinical picture. If necessary, it is confirmed by an X-ray examination of the neck in a lateral projection.

During laryngoscopy, the doctor identifies inflammatory changes in the larynx, swelling of the epiglottis, laryngeal cartilage, and vestibular folds. Palpation of the anterior neck may be tender, especially in the area of ​​the hyoid bone.

Patients with epiglottitis (especially if Hib infection is suspected) should always be examined for the presence of extralaryngeal foci of infection: pneumonia, cervical lymphadenitis, septic arthritis, and less commonly, meningitis.

Laboratory assessment should include a complete blood count with leukocyte count, blood culture for sterility, and in intubated patients - bacteriological examination with sampling of material from the epiglottis area.

Differential diagnosis

True croup (diphtheria) . The clinical picture of diphtheria is sometimes similar to that of epiglottitis. Symptoms—sore throat, malaise, and low-grade fever—usually appear gradually. Diphtheria is extremely rare in countries with high levels of immunization against diphtheria, tetanus and whooping cough.

False croup . The main symptom is a barking cough. It is not observed with epiglottitis. Children with croup usually feel comfortable lying on their back.

Bacterial tracheitis . There is an acute onset, a rapid increase in upper respiratory tract obstruction, and fever, which is similar to epiglottitis. Upon examination, no changes in the laryngopharynx are revealed, and radiographs reveal irregularities in the tracheal wall, and there are no changes in the epiglottis.

Peritonsillar abscess . In children with peritonsillar abscess or other infections of the oropharynx (retropharyngeal abscess, acute tonsillopharyngitis), the development of the disease is slower, breathing at the onset of the disease is not difficult, and intoxication is less pronounced than with epiglottitis.

Foreign bodies in the larynx, trachea and esophagus can cause complete or partial airway obstruction, which requires immediate treatment.

Angioedema (Quincke's edema) . Characterized by rapid onset without previous symptoms of cold or fever. The main manifestations are swelling of the lips and tongue, urticaria, dysphagia without hoarseness.

Upper respiratory tract trauma , including thermal burns.

If epiglottitis is suspected, the patient requires emergency medical care.

The main goal of managing patients with epiglottitis is to establish a definitive diagnosis and immediate treatment (before the onset of airway obstruction).

In standard cases, empirical antibacterial therapy is prescribed taking into account the most common pathogens, priority is given to third-generation cephalosporins.

In cases of severe disease, the presence of sepsis, meningitis, and a high probability of MRSA epiglottitis, the antibiotic Vancomycin is prescribed.

For patients with immunodeficiencies (including HIV infection), antibiotics are selected taking into account the most common pathogens in this group of patients, as well as based on the results of bacteriological testing, if possible.

The optimal duration of antibiotic therapy for epiglottitis is unknown. Most clinicians provide treatment for 7–10 days, depending on the patient's condition.

How is epiglottitis treated at the Rassvet Clinic?

If epiglottitis is suspected, the patient is immediately hospitalized. A full examination and treatment is carried out in the hospital.

In severe cases of life-threatening airway obstruction, intubation and tracheostomy are performed.

When the patient's condition clinically improves, we recommend replacing parenteral antibiotics with oral administration (an antibiotic in tablet form, of the same group).

There is no proven data on the benefits of routine administration of bronchodilators and glucocorticoids to patients with epiglottitis. These drugs do not reduce the duration or severity of the disease.

Source: https://klinikarassvet.ru/patients/zabolevanija/epiglottit/

Abscess of the epiglottis in a child photo

Inflammatory processes and suppuration in a child are provoked by a hemophilic infection, which affects all human organs: the respiratory and nervous system. Haemophilus influenzae enters the epiglottic cartilage, it causes an abscess, epiglottitis and epiglottis syndrome - these are acute pathologies that require urgent treatment.

The epiglottic cartilage conducts food and oxygen into the child’s body; the structure of the esophagus and respiratory tract depends on it. This prominent organ requires protection from various inflammatory processes. Most often, children from three to five years old suffer from inflammation of the epiglottis. Due to weak immunity, the disease occurs in acute form.

Causes

The main question that worries patients when visiting an ENT doctor concerns why the epiglottis is visible when examining the pharynx. Most often, they are asked by worried mothers who have noticed some additional structure below the root of their child’s tongue. But the cause of this phenomenon can only be determined by a specialist, having assessed all complaints and objective symptoms. Possible conditions include:

• Constitutional features.
• Epiglottis syndrome (“lump” in the throat).
• Inflammation (epiglottitis).
• Epiglottis cyst.

In most cases, there is no danger in seeing this cartilage when you open your mouth. And the doctor will reassure the patient by talking about the anatomical features of the larynx and their individual variations in each person. But we should not forget about other conditions, among which there is a rather serious pathology.

The structure and significance of the epiglottis

The epiglottis is an elastic, movable, prominent cartilage located at the beginning of the tracheal tube below the root of the tongue. It has two muscles: the aryepiglottis and the aryepiglottis. When they contract, the swallowing function is activated, the epiglottis descends and closes the passage to the trachea, food passes into the esophagus. This is the task of the organ, the epiglottis photo.

There are pits in the epiglottic cartilage that contain mucous glands. They are connected by nerves to the root of the tongue and the mucous membrane of the larynx. The glands consist of three layers and each has its own function:

1. The mucous membrane is located on the surface and moisturizes the cartilage to reduce friction with foreign objects and other organs.
2. The mucosal epithelium is part of the membrane containing elements for air purification.
3. The lamina mucosa is a tissue that contains: laryngeal glands, blood vessels and nerves.

Some people have individual characteristics regarding the location of the organ. In them, the epiglottis folds in half, blocks the path to the larynx and causes epiglottis syndrome.

Causes of diseases

The main cause is Haemophilus influenzae, an infection that affects the oral cavity. The routes of transmission are the mouth and nose. But there are other factors:

• alcoholic drinks and smoking;
• hot foods and drinks (burn);
• all kinds of throat injuries.

With inflammation, the organ enlarges, the functions of the epiglottis are disrupted, and this becomes an obstacle to the airways for carrying oxygen to the lungs. Bacteria attack the respiratory system, causing inflammatory processes. In the process, the organ changes shape, airway stenosis may appear, and death may occur. The risk zone includes :

• patients with allergic reactions;
• children from three to five years old;
• after operations on the spleen;
• men;
• people with weak immune systems.

The epiglottis has several pathologies :

1. Penetration of bacterial agents.
2. Age-related complications (after 30 years, the cartilage becomes deformed and begins to sink, which leads to difficulty breathing).
3. Epiglottitis is an infection with Haemophilus influenzae, the most complex inflammatory form. Symptoms occur suddenly: a person finds it difficult to inhale and exhale, breathing may stop and death may occur.

Epiglottis - elastic cartilage of the larynx

Abscess of the epiglottis in a child

Acute purulent inflammation of the larynx, formed in the area of ​​the epiglottic cartilage, symptoms:

1. The child’s body temperature rises to high levels, but sometimes may remain normal.
2. The presence of a foreign body is felt in the throat.
3. Sore throat gets worse when swallowing.
4. It's hard to swallow even liquids.
5. Nasality appears.
6. Breathing becomes difficult.
7. The lymph nodes become enlarged and painful.

In children, the disease occurs rapidly; symptoms appear within a few hours: the sore throat increases, the child has difficulty breathing, and drooling appears. Diagnosis of the child is carried out using radiography of the neck, pharyngoscopy, and taking a smear from the throat. The child is prescribed infusion and symptomatic therapy, antibiotic therapy.

A child aged two to five years more often develops epiglottitis, but now they are vaccinated against Haemophilus influenzae and epiglottitis in children has practically disappeared.

Epiglottis abscess is a complication of epiglottitis. Epiglottitis is an infectious process caused by:

The infectious agent penetrates the epiglottis from a burn or injury to the mucosa.

Diagnostics

The child develops symptoms: the presence of a foreign body in the throat, difficulty breathing, severe pain, shortness of breath, nasal voice. The doctor should examine the head and neck, determine the enlargement of the lymph nodes; they will be painful when touched. The larynx is then examined using a laryngeal speculum (laryngoscopy) or a flexible optical endoscope (fibrolaryngoscopy). The initial stages are expressed by redness of the larynx, thickening of the epiglottis and swelling. In the late period of development, the symptoms are slightly different: the edema is not pronounced, but a spherical formation is noticeable, thickening of the inflamed area with the presence of a yellow spot - purulent accumulation.

It is carried out in a hospital setting. Measures are taken: in the infiltrative stage to resolve the dense area of ​​inflammation (infiltrate). In the abscess stage, the abscess is opened (emptied). Antibiotics and anti-inflammatory drugs are prescribed intramuscularly and painkillers.

When an abscess has formed, surgical cleaning of the purulent cavity .
Under local anesthesia, the abscess is opened through the mouth with a special guttural knife.

Clinical picture

The development of the disease begins after a respiratory viral infection. Pathology develops rapidly. Within just a few hours, the patient is diagnosed with airway obstruction due to the presence of edema. In this way, respiratory failure is recorded.

Among the initial signs of epiglottitis is a sharp increase in body temperature. Eating becomes impossible, swallowing saliva becomes difficult. When breathing, you can hear a sound similar to a whistle. A person tries to inhale air, making great efforts to do so.

General signs

Symptoms also include:

• irritability and exhaustion;
• weaknesses;
• anxiety.

When examining the baby, a sore throat is noticeable. Redness spreads throughout the throat, but is most pronounced in its central part. The disease can be suspected based on other symptoms. Manifestations of epiglottitis in children can be different, taking into account the age and individual characteristics of the body.

The disease is characterized by the presence of a number of specific symptoms, such as:

1. A sharp increase in body temperature to very high values.
2. Painful sensations during swallowing, difficulty swallowing food.
3. Breathing complications. At the moment of inhalation, you can hear a characteristic whistling sound.
4. General weakness of the child, poor health.
5. Irritability, unstable emotional state, anxiety.
6. Redness and swelling of the laryngeal mucosa.
7. Over time, the painful sensations intensify; the child experiences pain not only when swallowing, but also when touching the neck.
8. Increased salivation.
9. Change in voice (hoarseness, muffledness).
10. Symptoms of oxygen deficiency, in particular, pale skin, bluish lips.

The clinical picture of the infiltrative form of the disease is supplemented by the following manifestations:

• dense coating on the tongue of a gray shade;
• change in facial expression (pain grimace) that occurs when swallowing;
• visually noticeable increase in the size of the epiglottis;
• suppuration that occurs on the mucous membrane of the larynx;
• dyspnea.

Causes of epiglottis abscess in an adult

• An epiglottis abscess develops as a complication of epiglottitis (inflammation of the epiglottis). The cause of epiglottitis is an infectious process, most often caused by: Haemophilus influenzae (the cause of acute infectious diseases of the respiratory system, central nervous system with the formation of purulent foci in various organs);
• pneumococcus (the causative agent of acute otitis media, pneumonia, meningitis, etc.).

An ENT doctor (otolaryngologist) will help in treating the disease

Stages of disease development

The initial stage of the disease is manifested by non-characteristic symptoms in the form of a cold. At the second stage, the symptoms become sharply more complicated, causing pain in the throat, increased temperature and difficulty breathing. The third stage is the appearance of complications, which are characterized by cyanosis of the lower and upper extremities due to lack of oxygen, excessive salivation and swelling of the nose. This clinical picture requires immediate hospitalization of the patient, otherwise the chances of saving the person are significantly reduced.

Epiglottitis is also divided into edematous (an excessively high pain threshold is observed) form, abscessive and infiltrative (characteristic of seizures, temperature readings rise to 38 degrees and a coating appears on the tongue).

Epiglottis syndrome - characterized by a feeling of a lump in the throat and making breathing slightly difficult

In this case, it is important to try to make swallowing movements as little as possible so as not to irritate the cartilage when it is raised

If the pain intensifies, you should contact your doctor for diagnostic x-rays. This will help determine the presence of a tumor and establish an accurate diagnosis. Women are at risk.

Diagnosis of epiglottis abscess in an adult

• Analysis of complaints and medical history: the patient complains of a sensation of a foreign body in the throat, severe pain in the throat, nasal voice, difficulty breathing, shortness of breath, etc.
• General examination: during examination of the head and neck, enlarged lymph nodes are determined, painful when palpated.
• During laryngoscopy (a method of examining the larynx using a laryngeal mirror) or fibrolaryngoscopy (examination of the larynx using a flexible optical endoscope), in the initial stages, redness of the larynx is detected, the epiglottis is thickened and swollen. In the later period of development of the abscess, the swelling is not very pronounced, a spherical formation is present, the inflamed area is compacted, and a yellow spot may be present in the center of the area of ​​inflammation - an accumulation of pus.

Epiglottitis in children

The disease usually begins with an upper respiratory tract infection. The pathology progresses very rapidly. After 2–5 hours, the airways are blocked due to inflammation and swelling of the epiglottis.

The main symptoms of this dangerous respiratory disease are:

• sore throat;
• heat;
• difficulty swallowing;
• irritability;
• noisy breathing, presence of whistling;
• a sore throat;
• exhaustion;
• high fever;
• anxiety.

It is difficult not to notice such changes in the patient’s appearance:

• sitting position leaning forward;
• neck stretching;
• flaring of the nostrils when trying to inhale;
• the mouth is open, the tongue is protruding.

Among the secondary features we note:

• muffled voice;
• salivation;
• bluish lips;
• difficulty breathing.

There are also certain differences in the symptoms of the disease depending on its form:

1. Edema form. It is characterized by severe pain when swallowing, pain on palpation of the neck, intoxication, and high fever (37 - 39 degrees). Patients exhibit bright diffuse hyperemia of the epiglottic mucosa. A blood test reveals an increase in ESR and leukocytosis.
2. Abscess form. Pus is visible (it shines through the edematous mucosa). Inspiratory dyspnea is present. The temperature is elevated (38 - 39 degrees).
3. Infiltrative form. It is characterized by an increase in temperature (38 - 39 degrees), severe pain in the throat, glassy edema of the epiglottis, and its thickening. The patient is bothered by a feeling of lack of air. There is a specific coating on the tongue (dirty gray).

Typically, the development of pathology is preceded by acute respiratory viral infection or tonsillitis. The disease manifests itself in children with a characteristic triad of symptoms: difficulty breathing, excessive salivation and sore throat. Most experience a dry throat, ear pain, and neck tenderness. The child becomes restless, excited, his voice changes to the point of aphonia, and the process of swallowing food is disrupted.

As the pathology progresses, shortness of breath increases, heart rate increases, acrocyanosis, sweating, and marbling of the skin appear. The child is in a semi-sitting position, gasping for air. It is impossible to lay him on his back. Breathing becomes stenotic, the pulse is weak, a rare dry cough appears, and vomiting “coffee grounds” is possible.

Inflammation of the epiglottis in children develops rapidly, symptoms increase and complete obstruction of the airways can occur within a few hours.

Children die from acute respiratory failure, aspiration of vomit, and hypoxic coma.

In adulthood, the disease practically does not occur. At the same time, men are more susceptible to the disease due to anatomical characteristics and lifestyle (alcoholism, drug use).

The course of epiglottitis in adults and adolescents is subacute, that is, symptoms (usually a sore throat) increase over several days. Only 25% of such patients complain of shortness of breath, 15% of drooling, and 10% have stridor.

Epiglottitis is predominantly observed in children, especially boys aged 2-5 years. It all starts with an ordinary sore throat or ARVI. Difficulty breathing, pain when swallowing, and excessive salivation appear. Then the following symptoms appear. It should be understood that the disease is rapidly progressive.

In adults, epiglottitis is practically not observed. If they do get sick, it is more often men than women. This is due to the structure of the laryngeal region in men, as well as bad habits that are rarely abused by women. In women, it also occurs due to alcohol or drug abuse.

Treatment of epiglottis abscess in an adult

• Treatment in a hospital setting.
• It comes down to taking measures to promote the resorption of the infiltrate (dense area of ​​inflammation) in the infiltrative stage or to emptying (opening) the abscess in the abscess stage. Medicines are prescribed: intramuscular injections of antibiotics (antimicrobials) and anti-inflammatory drugs;
• painkillers.

How to treat?

Treatment of inflammation of the epiglottis is performed in a hospital. In this case, folk remedies and diet are ineffective. Home treatment can only lead to death. Therefore, at the first symptoms of the disease, it is necessary to call an ambulance to transport the patient in a sitting position.

Doctors will relieve respiratory obstruction before arriving at the hospital. How to treat the disease at this stage? Inhalation with moist oxygen, oxygen mask, tracheal intubation, percutaneous puncture tracheostomy.

After arriving at the hospital, the same procedures are performed as before eliminating the air obstruction. What else is used to treat epiglottitis? The resuscitator and otolaryngologist prescribe the following medications:

1. Antibiotics - Cefotaxime, Ceftazidime, Cefuroxime.
2. Immunocorrectors – “Bronchomunal”, “Likopid”, “Polyoxidonium”.
3. Infusion solutions - “Disol”, “Lactosol”, “Ringera”.
4. Sedatives.
5. Inhalations with glucocorticoids.
6. Compresses based on dimexide on the neck.

Prevention of epiglottis abscess in adults

• Timely diagnosis and treatment of infectious diseases of the upper respiratory tract.
• Timely contact a specialist in case of foreign bodies getting into the larynx.
• Strengthening the body's protective functions: hardening in the autumn-winter period;
• avoiding hypothermia;
• daily walks in the fresh air (at least 2 hours);
• taking multivitamin complexes in the autumn-winter period;
• wearing protective bandages during periods of mass morbidity, for example, influenza;
• balanced and rational diet (eating foods high in fiber (vegetables, fruits, herbs), etc.).

Clinical recommendations and treatment regimen

Diagnosing epiglottitis requires emergency medical attention. This disease cannot be treated with conventional remedies at home.

The patient is provided with emergency care in the intensive care unit:

1. Inserting a plastic tube into the child's airway. This procedure is necessary to ensure free breathing. It is carried out under anesthesia.
2. An x-ray is taken. It is needed to ensure that the airway is blocked by the epiglottis.
3. Administration of antibiotics intravenously. This is necessary to destroy bacteria that provoke the development of the disease.
4. Injection into a vein of fluid, a nutrient to prevent dehydration and exhaustion.
5. Heart failure and respiration are monitored.
6. Humidify the atmosphere in the room where the child is located. This prevents the airways from drying out.

Medication

The patient spends about a week (5 – 7 days) in the clinic. Antibiotics are administered to him for 7–10 days.

Antibacterial therapy consists of the use of the following medications:

• "Ceftriaxone".
• "Cefuroxime".
• "Meropenem".
• "Cefotaxime"
• "Ceftazidime."

Immunocorrective therapy consists of administering:

• "Pentaglobin" (single dose of 5 ml/kg).
• Human immunoglobulin intravenously (dosage 1 g/kg, administered over three days).

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Medication

Since epiglottitis poses a serious threat to the health and life of children, the rules for conducting diagnostic measures, the procedure for hospitalization and the recommended treatment regimen have been developed by specialists and documented at the legislative level.

Clinical guidelines for the diagnosis and treatment of epiglottitis.

Causes

Why does inflammation of the epiglottis develop? The cause is considered to be Haemophilus influenzae, which is constantly present in the nose and sinuses in a passive state. Transmission occurs through airborne droplets, making the disease epidemic.

In addition to Haemophilus influenzae, pathogens include pneumococci, Candida fungus, Staphylococcus aureus, streptococci, as well as those that provoke the development of parainfluenza, herpes, lichen, and chickenpox. These microorganisms are not able to penetrate the epiglottis if there are no favorable factors for this.

Epiglottitis also appears due to:

• laryngeal injuries - wounds, blows, ruptures;
• chemical burns from alkalis or acids;
• thermal burn from very hot food;
• smoking abuse;
• drug addiction.

For any reason, the disease causes discomfort. Only medical methods can alleviate the condition. There is a greater risk of inflammation in:

• men (boys);
• African American persons;
• people who are in a large group;
• allergy sufferers;
• residents of megacities;
• people with reduced immunity or immunodeficiency;
• persons with lymphogranulomatosis - a blood disease;
• children with perinatal encephalopathy;
• persons after removal of the spleen.

Causes of the disease

Certain factors can cause an atypical process in the larynx, the main of which are carcinogenic:

• smoking. Smokers account for most of the development of malignant tumors. Since cigarette smoke contains a large amount of carcinogenic substances, which, interacting with the mucous membrane of the throat, can provoke mutation processes at the cellular level and lead to the development of a tumor;
• alcohol abuse. Ethyl alcohol contained in alcoholic beverages gets into

  on the mucous membrane of the throat and epiglottis, causing irritation and damage. Frequent processes of regeneration of damaged soft tissue cells are good soil for the formation of atypical cells. In combination with smoking, this factor is enhanced. Perhaps due to the fact that women drink alcohol and smoke less often, they suffer from the disease to a lesser extent;

• influence of industrial carcinogens. Women and men who work in hazardous industries, for example with chemicals, heavy metals, paint and varnish production, etc., are more susceptible to tumors than others. This factor also includes living in a very dusty city;
• precancerous diseases of the larynx. The reason for about 15% of cases of a malignant process in the throat are precancerous pathologies that were not eliminated in a timely manner. They can be observed equally in both women and men. Such diseases include papillomas, pachyderma, leukoplakia. Diseases that theoretically can lead to the formation of a tumor, but this happens extremely rarely, include fibroids and scars on the soft tissues of the throat left after burns, injuries, tuberculosis, etc.