Epiglottitis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Prince Tano Djan, BSc, MBChB [2]

## Overview

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Epiglottitis presents differently in children and adults. 80 to 95% of adults with epiglottitis present with sore throat and dysphagia[1] [2] whereas the predominant symptoms in infected children are high fever, muffled or hoarse voice, drooling and difficulty swallowing.[1] [3] A forward-leaning position with drooling while trying to breathe is typically seen in affected children. The child often appears acutely ill, anxious, and has very quiet and shallow breathing with the head held forward, on insisting on sitting up in bed. Adults usually have milder presentations and less commonly develop airway obstruction with respiratory distress.[4] Other common symptoms may include:[5][6][7][8] abnormal breathing sounds (stridor), chills, rigor, cyanosis, and Difficulty breathing

## Symptoms

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Epiglottitis presents differently in children and adults. 80 to 95% of adults with epiglottitis present with sore throat and dysphagia[1] [2] whereas the predominant symptoms in infected children are high fever, muffled or hoarse voice, drooling and difficulty swallowing.[1] [3] It is important to note that since the introduction of the Hemophilus Influenzae vaccination in many countries, the disease is becoming relatively more common in adults. The child often appears acutely ill, anxious, and has very quiet and shallow breathing with the head held forward, insisting on sitting up in bed. The early symptoms are insidious but rapidly progressive, and swelling of the throat may lead to cyanosis and asphyxiation. Cases in adults are most typically seen amongst abusers of crack cocaine and have a more subacute presentation.

Other symptoms may include:[5][6][7][8]

* Abnormal breathing sounds (stridor)
* Chills, shaking
* Cyanosis (blue skin coloring)
* Drooling
* Difficulty breathing (patient may need to sit upright and lean slightly forward to breathe)
* Difficulty swallowing
* Voice changes (hoarseness)
* General malaise and a globus sensation in the throat may be the initial symptom.

## References

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1. ↑ 1.0 1.1 1.2 1.3 Ossoff RH, Wolff AP, Ballenger JJ (1980). "Acute epiglottitis in adults: experience with fifteen cases". Laryngoscope. 90 (7 Pt 1): 1155–61. PMID 6967138.CS1 maint: Multiple names: authors list (link)
2. ↑ 2.0 2.1 Mayo-Smith MF, Spinale JW, Donskey CJ, Yukawa M, Li RH, Schiffman FJ (1995). "Acute epiglottitis. An 18-year experience in Rhode Island". Chest. 108 (6): 1640–7. PMID 7497775.CS1 maint: Multiple names: authors list (link)
3. ↑ 3.0 3.1 Mayo-Smith MF, Spinale JW, Donskey CJ, Yukawa M, Li RH, Schiffman FJ (1995). "Acute epiglottitis. An 18-year experience in Rhode Island". Chest. 108 (6): 1640–7. PMID 7497775.CS1 maint: Multiple names: authors list (link)
4. ↑ Cohen SR, Chai J (1978). "Epiglottitis. Twenty-year study with tracheotomy". Ann Otol Rhinol Laryngol. 87 (4 Pt 1): 461–7. PMID 686588.
5. ↑ 5.0 5.1 Tanaka S, Kikuchi S, Ohata A, Tsutsumi T, Ohki M (2015). "[A Clinical Study of Acute Epiglottitis]". Nihon Jibiinkoka Gakkai Kaiho. 118 (11): 1301–8. PMID 26827594.CS1 maint: Multiple names: authors list (link)
6. ↑ 6.0 6.1 Charles R, Fadden M, Brook J (2013). "Acute epiglottitis". BMJ. 347: f5235. doi:10.1136/bmj.f5235. PMID 24052580.CS1 maint: Multiple names: authors list (link)
7. ↑ 7.0 7.1 Mayo-Smith MF, Spinale JW, Donskey CJ, Yukawa M, Li RH, Schiffman FJ (1995). "Acute epiglottitis. An 18-year experience in Rhode Island". Chest. 108 (6): 1640–7. PMID 7497775.CS1 maint: Multiple names: authors list (link)
8. ↑ 8.0 8.1 Achong MR (1979). "Respiratory tract infections in adults". Can Fam Physician. 25: 1189–93. PMC 2383214. PMID 21297792.