What is epiglottitis in children?

The epiglottis is a flap of cartilage at the base of the tongue at the very back of the throat. It stops food from going into the windpipe (trachea) when swallowing. When the epiglottis becomes swollen and inflamed, it is called epiglottitis. Epiglottitis makes it hard to breathe. It gets worse quickly. If not treated, it can be life-threatening if there is so much swelling that air can’t get in or out of the lungs.

This condition most often affects children ages 2 to 6.

What causes epiglottitis in a child?

The main cause of epiglottitis in children is a bacterial infection that can be spread through the upper respiratory tract. Most cases are caused by the bacteria Haemophilus influenzae type B (Hib).

Experts don’t exactly know why some children get this health problem, and others do not. But they recommend the Hib vaccine for all children starting at age 2 months.

Which children are at risk for epiglottitis?

Children who don't get the Hib vaccine are at greater risk for epiglottitis.

What are the symptoms of epiglottitis in a child?

Symptoms may be a bit different for each child. In some children, epiglottitis starts with symptoms of an upper respiratory infection. Symptoms may include:

  • Sudden very sore throat
  • Fever
  • Drooling
  • Trouble swallowing
  • Muffled voice
  • Blue skin coloring
  • Stridor. This is a high-pitched sound that mostly happens as the child breathes in.

As the condition gets worse, your child may have trouble breathing and talking. He or she may:

  • Sit leaning forward
  • Keep his or her mouth open with the chin thrust forward
  • Look distressed or anxious

How is epiglottitis diagnosed in a child?

Epiglottitis is an emergency. The main concern is to make sure your child is able to breathe. Your child will likely need to go to the hospital. Once your child’s breathing is under control, a healthcare provider will look at your child’s airway. Usually this is enough to diagnose epiglottitis. In some cases, your child may need a laryngoscopy or X-ray. 

Don’t try to try to look at your child’s throat at home. This can cause more swelling that may fully block the airway.

How is epiglottitis treated in a child?

The treatment for epiglottitis calls for emergency care right away to stop the airway from being blocked. The medical staff will put in a breathing tube right away. They will closely watch your child’s airway. Your child may need a machine (ventilator) to help him or her breathe.

Treatment may also include:

  • IV (intravenous) therapy with antibiotics if the cause is a bacterial infection
  • Steroid medicine to ease airway swelling
  • IV fluids until the child can swallow again

How well your child recovers is related to how quickly treatment begins in the hospital. Once your child’s airway is safe and antibiotics are started, epiglottitis often stops getting worse within 24 hours. A full recovery takes longer and depends on your child’s condition.

What are possible complications of epiglottitis in a child?

Epiglottitis may lead to:

  • Cardiac arrest
  • Death

How can I help prevent epiglottitis in my child?

Epiglottitis that is caused by the bacteria Hib can be prevented with a vaccine. Once vaccinated, your child will have a lower chance of getting the condition. Epiglottitis caused by other germs can’t be prevented at this time. But such cases are much less common.

Experts recommend infants get 3 to 4 doses of the Hib vaccine. The main doses are given at 2 and 4 months of age or at 2, 4, and 6 months of age, based on the brand used by your healthcare provider. Your child will need a booster dose by 12 to 15 months of age.

If your child has epiglottitis, family members or other close contacts may be treated with rifampin. This medicine helps prevent the condition in people who may have been exposed to it.

When should I call my child’s healthcare provider?

Epiglottitis is a health emergency. Call your child’s healthcare provider or emergency personnel right away if you think your child may have it.

Key points about epiglottitis in children

  • Epiglottitis is when the epiglottis becomes swollen and inflamed. It can be a life-threatening condition.
  • Most cases in children are caused by the bacteria Hib.
  • Symptoms are usually sudden. They include severe sore throat, trouble swallowing, and problems breathing.
  • Treatment involves opening the child’s airway with a breathing tube. Your child may also get antibiotics or other medicines.
  • The Hib vaccine can prevent most cases of epiglottitis.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.