August 24, 2018, 16:15 Expert article: Kurbanov Kurban Samatovich 0 78
The pharynx is an important human organ in which the respiratory and digestive tracts intersect. Inflammation of the epiglottis is a rare but dangerous ENT disease, which entails a violation of vital functions for the person and even death. The danger of pathology is also in the fact that most often it affects children 2-4 years old, has an acute onset and serious consequences.
Most often, acute epiglottitis develops in patients living in large cities, with weakened immunity, susceptibility to allergies, as well as those whose working conditions are associated with inhalation of harmful chemicals. At risk are children attending kindergartens or having a history of perinatal encephalopathy. The disease provokes bacterial microflora, which exists on the mucous membrane of the nose and throat all the time, but does not show its pathological properties in the absence of provoking factors. Streptococci, staphylococci, pneumococci, hemophilus bacillus, fungi are the most frequent provocateurs of inflammation of the epiglottis. Other reasons include:
- chemical and thermal burns;
- mechanical injuries (blow, wound) or injury to a foreign body that has got into the respiratory tract;
- use of narcotic substances.
Pathogenesis is associated with capillary rupture under the influence of a provoking factor. As a result, the epithelial barrier is violated, and infiltration, edema and inflammation develop. The rapid growth of pathological microflora leads to the spread of the process to nearby tissues and structures of the pharynx and larynx. As a result of edema, mucous membranes completely or partially overlap the air flow paths, which leads to respiratory failure and suffocation.
Symptoms of epiglottitis
Disease in adults begins with signs of a common cold. Rhinitis, sneezing, pain and redness in the throat appear, the temperature rises, intoxication increases. Inflammation of the epiglottis in children progresses faster than in older patients, and the appearance of common nonspecific symptoms is very quickly supplemented by such characteristic signs as:
- noisy heavy breathing;
- difficulty swallowing;
- increased salivation;
- increasing cyanosis of the lips and fingers;
- forced sitting posture with an inclination (extended neck, open mouth with tongue sticking out).
Epiglottitis in children may be accompanied by vomiting “coffee grounds” and dry cough. There may be other symptoms indicating the severity and form of the pathology. For example, with infiltration, a raid appears in the gray language, a noticeable swelling of the epiglottis with the naked eye, and the presence of purulent foci on it. Abscess form most severe. It can be fatal against the background of a pronounced expiratory and inspiratory dyspnea, which leads to the progression of respiratory failure and convulsions.
Only a doctor can diagnose inflammation of the epiglottis in time and provide the correct emergency care. The loss of precious time for self-treatment can lead to irreparable consequences.
It is impossible to recognize the disease on its own, especially the initial edematous form. Only a medical examination, tests and specific diagnostic procedures can accurately indicate the presence of epiglottitis. Often the patient seeks qualified help when swelling leads to respiratory failure. In this case, a direct examination of the epiglottis is possible only after the obstruction has been removed. Laboratory and instrumental examinations will help to make the correct diagnosis, such as:
- microbiological examination of the material from the pharynx;
- throat radiograph;
- blood test.
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Conducted exclusively in the hospital. Emergency care is provided by an ambulance on the way to the hospital. It consists in the normalization of breathing. Depending on the severity of the condition, puncture tracheotomy or the supply of humidified oxygen through a mask can be performed. Transportation of the patient is made necessarily in a sitting position.
Resuscitation in a hospital begins with the stabilization of the patient and the restoration of normal breathing. For the period while diagnostic procedures will be carried out, the patient is monitored for breathing, heart activity, blood pressure level. Infusion therapy is carried out with nutrient solutions in order to eliminate or prevent dehydration and intoxication. After receiving the results of laboratory studies make the decision to conduct adequate antibiotic therapy.
Cefuroxime is one of the most commonly prescribed antibiotics for such a diagnosis.
Antibiotic treatment provides for a 7-10-day course of intramuscular or intravenous administration of representatives of the cephalosporin or penicillin series. The purpose of a particular drug is based on the results of bacteriological studies on the sensitivity of the bacterial flora. Most often used drugs such as:
Treatment is supplemented with immunomodulators, sedatives, inhalation using glucocorticosteroids.
How to avoid?
Inflammation of the epiglottis is rare, since there are special vaccines AKT-Hib and Pentaxim. Vaccination of 2–7-year-old children by them is the most effective prevention of the development of the disease. Among the non-specific methods of prevention that can help avoid infection, it can be noted: individual hygiene, balanced nutrition, strengthening the immune system, protection of the pharynx from injuries, burns and the effects of chemical toxic substances.