acute epiglottitis
Introduction
Introduction to acute epiglottis Acute epiglottisitis (acuteepiglottitis), also known as supraglottic laryngitis or epiglottis anterior angina, is a special type of epiglottis and surrounding tissues that mainly affect the upper glottic region of the throat (including epiglottis, phlegm, etc.) The acute inflammatory lesions are characterized by high edema of epiglottis. Acute epiglottis is one of the most serious cases of laryngology. It can occur in children and adults. It is mainly characterized by systemic poisoning, swallowing and difficulty breathing. The acute epiglottis disease progresses rapidly, and most patients can be cured by timely treatment. A small number of patients are ill and quickly suffocate and have a high mortality rate. The most common cause of infection is this disease. In the past, the most common pathogen was Haemophilus influenzae type B. After developing a vaccine against this pathogen in European and American countries, the number of acute epiglottis caused by Haemophilus influenzae type B has gradually decreased. Other pathogenic pathogens include: Haemophilus parainfluenzae, group A streptococci, Streptococcus pneumoniae, Staphylococcus aureus, branching bacteria, streptococci, Enterobacter cloacae, Escherichia coli, Fusarium oxysporum, pneumonia Klebsiella, Neisseria meningitidis and so on. The virus can also cause the disease, such as varicella-zoster virus, herpes simplex virus type I, and the like. In patients with low immunity, there may also be infections of fungi such as Candida or Aspergillus. basic knowledge The proportion of sickness: 0.01%-0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: pneumonia, pulmonary edema
Cause
Acute epiglottis
Infection (40%):
The most common cause of this disease. In the past, the most common pathogen was Haemophilus influenzae type B. After developing a vaccine against this pathogen in European and American countries, the number of acute epiglottis caused by Haemophilus influenzae type B has gradually decreased. Other pathogenic pathogens include: Haemophilus parainfluenzae, group A streptococci, Streptococcus pneumoniae, Staphylococcus aureus, branching bacteria, streptococci, Enterobacter cloacae, Escherichia coli, Fusarium oxysporum, pneumonia Klebsiella, Neisseria meningitidis and so on. The virus can also cause the disease, such as varicella-zoster virus, herpes simplex virus type I, and the like. In patients with low immunity, there may also be infections of fungi such as Candida or Aspergillus.
Trauma (20%):
Thermal damage (high temperature drinks, inhalation of steam, etc.), mechanical damage (foreign body trauma, iatrogenic injury, etc.), chemical damage (irritating harmful gases, irritating foods, etc.), radiation damage, etc. can cause inflammation of the epiglottis mucosa The lesion, followed by edema.
Allergic reaction (10%):
Reacts to certain allergens due to diet, drugs or insect bites. Systemic allergic reactions can cause high edema in the epiglottis mucosa and phlegm.
Acute inflammation of adjacent organs (5%):
Acute inflammation such as acute tonsillitis, pharyngitis, stomatitis, rhinitis and other surrounding organs can spread and invade the epiglottis mucosa, causing edema. Can also be secondary to acute infectious diseases.
Prevention
Acute epiglottis prevention
Prevention method
To prevent the occurrence of acute epiglottis, exercise should be strengthened to enhance the body's resistance. For the acute inflammation of the adjacent organs of the epiglottis, it is necessary to treat them in time to prevent the spread of infection. To maintain oral hygiene, quit smoking and alcohol, eat less spicy food. People with diabetes should pay attention to controlling blood sugar.
Preventive drug
For children, a Haemophilus influenzae type B vaccine can be administered to prevent infection of the pathogen. In adults, injections are not recommended, except in special populations with low immunity, such as sickle cell anemia, splenectomy, and tumors that affect immune function.
Complication
Acute epiglottis complications Complications Pneumonia pulmonary edema
Local complications
Epiglottis abscess, neck cellulitis, epiglottis cartilage metaplasia.
Distant complications
Vocal cord granuloma, cervical lymphadenitis, necrotizing fasciitis, meningitis, pneumonia, pulmonary edema, empyema, pneumothorax, mediastinal emphysema, pericarditis, septic arthritis, etc.
Systemic complications
Infectious toxic shock: more common in children.
Difficulty breathing, suffocation and death.
Symptom
Acute symptoms of epiglottis Symptoms common symptoms epiglottis, sore throat, chills, difficulty breathing, itchy throat
(1) Acute onset, fever, chills, headache, general malaise, and severe breathing difficulties.
(2) The sore throat is severe and it is aggravated when swallowing, so saliva overflows often.
(3) Because of the swelling of the episode, the language is vague and clear, like the contents of the mouth.
(4) Under the indirect laryngoscopy, the epiglottis is swollen and the tongue is especially swollen. When it is heavy, it can be spherical. If the abscess is formed, the yellow and white pus can be seen on the tongue.
Examine
Acute epiglottis test
Laryngoscopy
Direct laryngoscopes, fiber laryngoscopes, etc., such as indirect laryngoscopy observations are dissatisfied, such tests can be used to help diagnose.
Laboratory inspection
Blood routine: such as increased white blood cells, suggesting infection or inflammation.
Arterial blood gas analysis: hypoxia performance such as decreased oxygen saturation.
Blood culture: A type of pathogen that can cause an infection.
Immunological examination: antibodies such as specific pathogens can be found.
Film degree exam
Flat side of the larynx: normal epiglottis is a thin, curved piece of soft tissue shadow, separated from the tongue root by the air of the epiglottis. In the case of acute epiglottis, the swelling of the epiglottis will increase. At the same time, the airway shadow of the throat and throat will be reduced, the boundary will be clear, and the epiglottis can disappear.
Neck CT: This test has a delay in the risk of illness. Mainly used to observe the formation of abscesses, and other diseases such as deep neck abscess, throat foreign body and so on. CT can be seen in the epiglottis and its surrounding tissue thickening, disappeared before the epiglottis gap.
Neck MRI: This test also has a delay in the risk of illness. Mainly used to exclude other diseases and to identify related complications.
Diagnosis
Diagnosis of acute epiglottis
diagnosis
For patients with acute sore throat, no significant changes in the oropharynx mucosa and tonsil examination, the possibility of acute epiglottis should be considered. Indirect laryngoscopy can confirm the diagnosis. Laboratory examinations and imaging examinations are not necessary for diagnosis. If they have been diagnosed, they should be omitted as much as possible to avoid delays in treatment and rescue.
Differential diagnosis
Simple laryngeal edema
Acute onset, rapid throat, hoarseness, difficulty breathing, and even suffocation. There is often a foreign body sensation in the throat and difficulty swallowing. Check the body to see diffuse edema of the laryngeal mucosa, pale, bright surface, phlegm will be swollen and swollen in the shape of a sausage, epiglottis can also be swollen.
Throat diphtheria
The onset is slow, low fever, hoarseness, no difficulty in swallowing, slow development of breathing difficulties, and severe cough. Check the body to see a fake membrane that is difficult to wipe off the throat. The pathogen is diphtheria.
Acute laryngotracheal bronchitis
The onset is generally more urgent, with more high fever, there may be hoarseness, no difficulty in swallowing, dyspnea development is generally faster, paroxysmal cough. Check the body to see the mucosal congestion and swelling under the glottis. The pathogen is often Staphylococcus aureus or Streptococcus.
Throat foreign body
If you have a history of eating foreign bodies, you can find foreign bodies.
