Epiglottitis causes: Difference between revisions

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{{Epiglottitis}}
{{Epiglottitis}}
 
{{CMG}}; {{AE}} {{Alonso}}; {{Ochuko}} {{PTD}}
{{CMG}}


==Overview==
==Overview==
Prior to the introduction of [[Haemophilus Influenzae B|Haemophilus]] influenza type b vaccine,<ref name="Sch20152">{{cite book|last1=Schlossberg|first1=David|title=Clinical infectious disease|date=2015|isbn=9781107038912|page=202|edition=Second|url=https://books.google.ca/books?id=meFwBwAAQBAJ&pg=PA202}}</ref> [[Haemophilus influenzae|H. influenza]] was the most common culprit of [[epiglottitis]]. In recent literature, group A [beta]-hemolytic [[Streptococcus|Streptococci]] is more commonly observed to be the cause. The disease used to be mostly found in pediatric age group of 3 to 5 years. However, recent trend favors adults as most commonly affected individuals.<ref name="pmid27031010">{{cite journal| author=Lichtor JL, Roche Rodriguez M, Aaronson NL, Spock T, Goodman TR, Baum ED| title=Epiglottitis: It Hasn't Gone Away. | journal=Anesthesiology | year= 2016 | volume= 124 | issue= 6 | pages= 1404-7 | pmid=27031010 | doi=10.1097/ALN.0000000000001125 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27031010  }} </ref> Other pathogens such as ''[[escherichia coli]]'', ''[[candida albicans]]'', or ''[[Kingella|kingella kingae]]'' may be encountered in immunocompromised hosts. Occasionally, noninfectious causes examples trauma from foreign objects inhalation and chemical burns have been found to cause [[epiglottitis]].


==Causes==
==Causes==
Prior to the introduction of [[Haemophilus Influenzae B|Haemophilus]] influenza type b vaccine,<ref name=Sch2015>{{cite book|last1=Schlossberg|first1=David|title=Clinical infectious disease|date=2015|isbn=9781107038912|page=202|edition=Second|url=https://books.google.ca/books?id=meFwBwAAQBAJ&pg=PA202}}</ref> H. influenza was the common culprit of [[epiglottitis]]. In recent literature, group A [beta]-hemolytic [[Streptococcus|Streptococci]] is more commonly observed to be the cause. The disease used to be mostly found in pediatric age group of 3 to 5 years. However, recent trend favors adults as most commonly affected individuals.<ref name="pmid27031010">{{cite journal| author=Lichtor JL, Roche Rodriguez M, Aaronson NL, Spock T, Goodman TR, Baum ED| title=Epiglottitis: It Hasn't Gone Away. | journal=Anesthesiology | year= 2016 | volume= 124 | issue= 6 | pages= 1404-7 | pmid=27031010 | doi=10.1097/ALN.0000000000001125 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27031010  }} </ref>
===Life-Threatening Causes===
Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.  [[Epiglottitis]] is a life-threatening condition and must be treated as such irrespective of the causes.<ref name="pmid26614243">{{cite journal| author=Richards AM| title=Pediatric Respiratory Emergencies. | journal=Emerg Med Clin North Am | year= 2016 | volume= 34 | issue= 1 | pages= 77-96 | pmid=26614243 | doi=10.1016/j.emc.2015.08.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26614243  }} </ref>


[[Epiglottitis]] is a life-threatening [[disease]]. The [[epiglottis]] is a piece of [[cartilage]] at the back of the [[tongue]] that closes off the [[windpipe]] when [[swallowing]]. It keeps food from entering the [[airways]], so you don't [[cough]] or [[choke]] after [[swallowing]].
===Common Causes===
Common causes of epiglottitis include:<ref name="pmid2357085">{{cite journal| author=Trollfors B, Nylén O, Strangert K| title=Acute epiglottitis in children and adults in Sweden 1981-3. | journal=Arch Dis Child | year= 1990 | volume= 65 | issue= 5 | pages= 491-4 | pmid=2357085 | doi= | pmc=PMC1792127 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2357085  }} </ref><ref name="pmid27031010">{{cite journal| author=Lichtor JL, Roche Rodriguez M, Aaronson NL, Spock T, Goodman TR, Baum ED| title=Epiglottitis: It Hasn't Gone Away. | journal=Anesthesiology | year= 2016 | volume= 124 | issue= 6 | pages= 1404-7 | pmid=27031010 | doi=10.1097/ALN.0000000000001125 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27031010  }} </ref>
*[[streptococci|Beta-hemolytic streptococci]]
*[[Haemophilus influenzae serotype B infection]]
*[[Staphylococcus aureus]]
*[[Streptococcus pneumoniae]]


[[Epiglottitis]] is [[swelling]] of the [[epiglottis]], which leads to [[breathing]] problems. [[Swelling]] of the [[epiglottis]] is usually caused by the [[bacteria]] [[Haemophilus influenzae]] ([[H. influenzae]]), although it may be caused by other [[bacteria]] or [[viruses]] such as ''[[Streptococcus pneumoniae]]'' or ''[[Streptococcus pyogenes]]''. [[Upper respiratory infections]] can lead to [[epiglottitis]]. Medicines or [[diseases]] that weaken the [[immune system]] can make adults more prone to [[epiglottitis]].
===Less common causes===
Less common causes of epiglottitis include:<ref name="pmid24052580">{{cite journal| author=Charles R, Fadden M, Brook J| title=Acute epiglottitis. | journal=BMJ | year= 2013 | volume= 347 | issue=  | pages= f5235 | pmid=24052580 | doi=10.1136/bmj.f5235 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24052580  }}</ref><ref name="pmid25926662">{{cite journal| author=Shah KM, Carswell KN, Paradise Black NM| title=Prolonged Stridor and Epiglottitis With Concurrent Bacterial and Viral Etiologies. | journal=Clin Pediatr (Phila) | year= 2016 | volume= 55 | issue= 1 | pages= 91-2 | pmid=25926662 | doi=10.1177/0009922815584221 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25926662  }} </ref>
*Noninfectious causes examples include:
** Trauma from foreign objects inhalation
**Chemical burns
*Viruses (including herpes simplex)
*Fungi (''Aspergillus'' spp and ''Candida albicans'')


[[Epiglottitis]] is most common in children between 2 and 6 years old. Rarely, [[epiglottitis]] can occur in adults, and it may be easily overlooked in such patients.
===Causes by Organ System===


The occurrence of [[epiglottitis]] has decreased dramatically in the United States since the [[H. influenzae type B]] ([[Hib]]) [[Hib vaccine|vaccine]] became a routine childhood [[immunization]] in the late 1980s.
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Chloramine|Chloramines in pool water]], [[Recreational drug use|smoking illicit drugs]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[cyst|Vallecular cyst]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Gastroesophageal reflux]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Hereditary angioedema]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Bone marrow transplantation]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Laryngeal mask airway]], [[Tonsillectomy|tonsillectomy complication]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Aeromonas|Aeromonas hydrophilia]], [[aspergillus]], [[Bacteroides|bacteroides melaninogenicus]], [[streptococcus|beta-hemolytic streptococcus]], [[candida albicans]], [[citrobacter|citrobacter diversus]], [[cytomegalovirus]], [[eikenella|eikenella corrodens]], [[enterobacter cloacae]], [[Epstein-Barr virus]], [[escherichia coli]], [[fusobacterium]], [[haemophilus influenzae]], [[haemophilus|haemophilus parainfluenzae]], [[herpes simplex virus]], [[histoplasma capsulatum]], [[influenza B virus]], [[kingella|kingella kingae]], [[klebsiella pneumoniae]], [[moraxella catarrhalis]], [[mycobacterium tuberculosis]], [[neisseria meningitidis]], [[parainfluenza virus]], [[pasteurella multocida]], [[peptostreptococcus]], [[propionibacterium]], [[pseudomonas aeruginosa]], [[serratia marcescens]], [[staphylococcus aureus]], [[micrococcaceae|stomatococcus mucilaginosus]], [[streptococcus pneumoniae]], [[streptococcus pyogenes]], [[streptococcus viridans]], [[streptococcus milleri group|streptococcus milleri]], [[varicella-zoster virus]], [[vibrio vulnificus]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[lymphangioma|Laryngeal lymphangioma]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[foreign body|Foreign body ingestion]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Allergic reactions]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[foreign body|Foreign body ingestion]], [[burn overview|thermal injury]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[choking medical therapy|Blind finger sweep]], [[caustic|caustic ingestion]], [[chloramine|chloramines in pool water]], [[drinking water|hot water ingestion]], [[foreign body|Foreign body ingestion]], [[recreational drug use|smoking illicit drugs]], [[burn overview|thermal injury]], [[cyst|vallecular cyst]]
|-
|}
 
===Causes in Alphabetical Order===
{{columns-list|
* [[Aeromonas|Aeromonas hydrophilia]]
* [[Allergic reactions]]
* [[Aspergillus]]
* [[Bacteroides|Bacteroides melaninogenicus]]
* [[streptococcus|Beta-hemolytic streptococcus]]
* [[choking medical therapy|Blind finger sweep]]
* [[Bone marrow transplantation]]
* [[Candida albicans]]
* [[Caustic|Caustic ingestion]]
* [[Chloramine|Chloramines in pool water]]
* [[Citrobacter|Citrobacter diversus]]
* [[Cytomegalovirus]]
* [[Eikenella|Eikenella corrodens]]
* [[Enterobacter cloacae]]
* [[Epstein-Barr virus]]
* [[Escherichia coli]]
* [[foreign body|Foreign body ingestion]]
* [[Fusobacterium]]
* [[Gastroesophageal reflux]]
* [[Haemophilus influenzae]]
* [[Haemophilus|Haemophilus parainfluenzae]]
* [[Hereditary angioedema]]
* [[Herpes simplex virus]]
* [[Histoplasma capsulatum]]
* [[drinking water|Hot water ingestion]]
* [[Influenza B virus]]
* [[Kingella|Kingella kingae]]
* [[Klebsiella pneumoniae]]
* [[lymphangioma|Laryngeal lymphangioma]]
* [[Laryngeal mask airway]]
* [[Moraxella catarrhalis]]
* [[Mycobacterium tuberculosis]]
* [[Neisseria meningitidis]]
* [[Parainfluenza virus]]
* [[Pasteurella multocida]]
* [[Peptostreptococcus]]
* [[Propionibacterium]]
* [[Pseudomonas aeruginosa]]
* [[Serratia marcescens]]
* [[Recreational drug use|Smoking illicit drugs]]
* [[Staphylococcus aureus]]
* [[micrococcaceae|Stomatococcus mucilaginosus]]
* [[Streptococcus pneumoniae]]
* [[Streptococcus pyogenes]]
* [[Streptococcus viridans]]
* [[Streptococcus milleri group|Streptococcus milleri]]
* [[burn overview|Thermal injury]]
* [[Tonsillectomy|Tonsillectomy complication]]
* [[Varicella-zoster virus]]
* [[Cyst|Vallecular cyst]]
* [[Vibrio vulnificus]]
}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Laryngology]]
[[Category:Medical emergencies]]
[[Category:Bacterial diseases]]
[[Category:Disease]]
[[Category:Pulmonology]]
[[Category:Otolaryngology]]
[[Category:Pediatrics]]
[[Category:Emergency medicine]]
[[Category:Crowdiagnosis]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]

Latest revision as of 21:36, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]; Ogheneochuko Ajari, MB.BS, MS [3] Prince Tano Djan, BSc, MBChB [4]

Overview

Prior to the introduction of Haemophilus influenza type b vaccine,[1] H. influenza was the most common culprit of epiglottitis. In recent literature, group A [beta]-hemolytic Streptococci is more commonly observed to be the cause. The disease used to be mostly found in pediatric age group of 3 to 5 years. However, recent trend favors adults as most commonly affected individuals.[2] Other pathogens such as escherichia coli, candida albicans, or kingella kingae may be encountered in immunocompromised hosts. Occasionally, noninfectious causes examples trauma from foreign objects inhalation and chemical burns have been found to cause epiglottitis.

Causes

Prior to the introduction of Haemophilus influenza type b vaccine,[3] H. influenza was the common culprit of epiglottitis. In recent literature, group A [beta]-hemolytic Streptococci is more commonly observed to be the cause. The disease used to be mostly found in pediatric age group of 3 to 5 years. However, recent trend favors adults as most commonly affected individuals.[2]

Life-Threatening Causes

Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated. Epiglottitis is a life-threatening condition and must be treated as such irrespective of the causes.[4]

Common Causes

Common causes of epiglottitis include:[5][2]

Less common causes

Less common causes of epiglottitis include:[6][7]

  • Noninfectious causes examples include:
    • Trauma from foreign objects inhalation
    • Chemical burns
  • Viruses (including herpes simplex)
  • Fungi (Aspergillus spp and Candida albicans)

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning Chloramines in pool water, smoking illicit drugs
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat Vallecular cyst
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Gastroesophageal reflux
Genetic Hereditary angioedema
Hematologic Bone marrow transplantation
Iatrogenic Laryngeal mask airway, tonsillectomy complication
Infectious Disease Aeromonas hydrophilia, aspergillus, bacteroides melaninogenicus, beta-hemolytic streptococcus, candida albicans, citrobacter diversus, cytomegalovirus, eikenella corrodens, enterobacter cloacae, Epstein-Barr virus, escherichia coli, fusobacterium, haemophilus influenzae, haemophilus parainfluenzae, herpes simplex virus, histoplasma capsulatum, influenza B virus, kingella kingae, klebsiella pneumoniae, moraxella catarrhalis, mycobacterium tuberculosis, neisseria meningitidis, parainfluenza virus, pasteurella multocida, peptostreptococcus, propionibacterium, pseudomonas aeruginosa, serratia marcescens, staphylococcus aureus, stomatococcus mucilaginosus, streptococcus pneumoniae, streptococcus pyogenes, streptococcus viridans, streptococcus milleri, varicella-zoster virus, vibrio vulnificus
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Laryngeal lymphangioma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Foreign body ingestion
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Allergic reactions
Sexual No underlying causes
Trauma Foreign body ingestion, thermal injury
Urologic No underlying causes
Miscellaneous Blind finger sweep, caustic ingestion, chloramines in pool water, hot water ingestion, Foreign body ingestion, smoking illicit drugs, thermal injury, vallecular cyst

Causes in Alphabetical Order

References

  1. ↑ Schlossberg, David (2015). Clinical infectious disease (Second ed.). p. 202. ISBN 9781107038912.
  2. ↑ 2.0 2.1 2.2 Lichtor JL, Roche Rodriguez M, Aaronson NL, Spock T, Goodman TR, Baum ED (2016). "Epiglottitis: It Hasn't Gone Away". Anesthesiology. 124 (6): 1404–7. doi:10.1097/ALN.0000000000001125. PMID 27031010.
  3. ↑ Schlossberg, David (2015). Clinical infectious disease (Second ed.). p. 202. ISBN 9781107038912.
  4. ↑ Richards AM (2016). "Pediatric Respiratory Emergencies". Emerg Med Clin North Am. 34 (1): 77–96. doi:10.1016/j.emc.2015.08.006. PMID 26614243.
  5. ↑ Trollfors B, Nylén O, Strangert K (1990). "Acute epiglottitis in children and adults in Sweden 1981-3". Arch Dis Child. 65 (5): 491–4. PMC 1792127. PMID 2357085.
  6. ↑ Charles R, Fadden M, Brook J (2013). "Acute epiglottitis". BMJ. 347: f5235. doi:10.1136/bmj.f5235. PMID 24052580.
  7. ↑ Shah KM, Carswell KN, Paradise Black NM (2016). "Prolonged Stridor and Epiglottitis With Concurrent Bacterial and Viral Etiologies". Clin Pediatr (Phila). 55 (1): 91–2. doi:10.1177/0009922815584221. PMID 25926662.
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