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Acute Epiglottitis

Acute inflammation of the epiglottis and airway emergency

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is Acute Epiglottitis?

Acute epiglottitis (supraglottitis) is an inflammation of the epiglottis, aryepiglottic folds, and surrounding supraglottic tissues. Historically caused by Haemophilus influenzae type b (Hib) in children, the epidemiology has shifted with widespread Hib vaccination, making the disease now more common in adults and caused by streptococci, staphylococci, and viral pathogens.

The hallmark is rapidly progressive supraglottic edema that can result in life-threatening airway obstruction within hours. Classic clinical features include the four Ds: dysphagia, drooling, dysphonia (muffled 'hot potato' voice), and distress. Patients typically prefer the tripod position to maintain airway patency.

Diagnosis prioritizes airway safety: in suspected cases, examination should occur in a controlled setting (operating room) with airway management readiness. Lateral neck radiograph may show the 'thumb sign' (swollen epiglottis), but flexible laryngoscopy is the gold standard, performed cautiously. Treatment includes airway protection (intubation in 50-60% or surgical airway), broad-spectrum IV antibiotics (third-generation cephalosporin), and supportive care.

Symptoms

Severe sore throat with rapid onset
Dysphagia and odynophagia
Drooling and inability to swallow saliva
Muffled 'hot potato' voice
Stridor and respiratory distress
Tripod or sniffing position
High fever with toxic appearance

Risk Factors

Unvaccinated children (Hib)
Adult immunocompromised state
Diabetes mellitus
Recent upper respiratory infection
Smoking and chronic alcohol use
Thermal or caustic injury to upper airway
Crack cocaine use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Rapidly worsening sore throat with fever
  • Drooling or inability to swallow
  • Difficulty breathing or stridor
  • Patient sitting forward in tripod position
  • Muffled voice or dysphonia
  • Cyanosis or impending airway obstruction
  • Any suspicion of epiglottitis warrants emergency department evaluation

Treatment Methods

01
Immediate airway evaluation in controlled setting
02
Endotracheal intubation by experienced operator
03
Surgical airway readiness (tracheotomy/cricothyroidotomy)
04
Broad-spectrum IV antibiotics (ceftriaxone +/- vancomycin)
05
IV corticosteroids (controversial but often used)
06
Humidified oxygen and supportive care in ICU
07
Hib vaccination check and household contact prophylaxis

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.