Epiglottitis in Children

Sunday, June 20, 2010

a. Definition
Epiglottitis is an infection which attacks epiglotits and supraglotis structure, makes acute airway obstruction and cause death if not treated. Acute epiglottis an emergency so that the diagnosis should be established as quickly as possible, but must be done quickly and precisely in order to reduce mortality. The situation that is potentially deadly and dramatic this usually occurs in Justify Full
children aged 2-7 years, peak incidence occurs at age 3.5 years.

b. Etiology
Epiglotitis almost always caused by Hemophilus influenza type B. Other causes are S. aureus, S. pneumonia, C.albicans, viruses and trauma.

c. Clinical manifestations
Epiglotitis marked by a sudden high fever and severe sore throat, shortness of breath, followed by symptoms of progressive airway obstruction quickly, can deteriorate into total obstruction of breathing and death.In younger children initially good general condition, often appear either before sleep but then wake up at night with high fever, afoni, protruding tongue, accompanied by severe breathing (respiratory disstres) moderate or severe stridor with inspiration.
Older children, initially complained of sore throat and dysphagia, the patient prefers a sitting position, body bent forward with his mouth open and neck extension. Respiratory crisis can occur within minutes or start 3-4 days after the occurrence of rhinitis. Inconvenience or substernal chest pain under the front there and could often compounded by coughing. When the condition getting worse, patients may be disturbed by the sound of whistling during respiration (may ronkhi), chest pain, and sometimes by shortness of breath.

d. Diagnosis
The diagnosis is based on the discovery of a large epiglottis, swollen and red cherries, with checks or direct laryngoscopy. On radiological examination showed picture thumb sign.

Thumb Sign

e. Treatment


Provision of oxygen
Provision of weight adjusted intravenous fluids and hydration status
Provision of Salin Sulfate inhalation
Intubation or tracheostomy
Antibiotics
Antibiotics given intravenously in the form of third-generation cephalosporins (cefotaxim or ceftriaxone), sefotaxim (50-100 mg / kg / day in three divided doses) for 7-10 days and free child fever two days, while ceftriaxone (50-100 mg / kg / day) can be given a single dose for 5 days.


References
1. http://www.waent.org
2. http://www.virtualpediatrichospital.org
3. http://emedicine.medscape.com
4. http://www.drugs.com/cg/acute-epiglottitis-in-children.html
5. http://www.privatehealthcare.co.uk/diseases/ear-nose-throat/epiglottitis-children
6. http://www.emedicinehealth.com/epiglottitis/article_em.htm

2 comments:

Mbah Dukun Bagong at: December 4, 2010 at 3:35 PM said...

usefull article

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