Épiglottite

Epiglottitis is the inflammation of the epiglottis—the flap at the base of the tongue that prevents food entering the trachea (windpipe). Symptoms are usually rapid in onset and include trouble swallowing which can result in drooling, changes to the voice, fever, and an increased breathing rate. As the epiglottis is in the upper airway, swelling can interfere with breathing. People may lean forward in an effort to open the airway. As the condition worsens, stridor and bluish skin may occur. Epiglottitis was historically mostly caused by infection by H. influenzae type b (commonly referred to as "Hib"). With vaccination, it is now more often caused by other bacteria, most commonly Streptococcus pneumoniae, Streptococcus pyogenes, or Staphylococcus aureus. Predisposing factors include burns and trauma to the area. The most accurate way to make the diagnosis is to look directly at the epiglottis. X-rays of the neck from the side may show a "thumbprint sign" but the lack of this sign does not mean the condition is absent. An effective vaccine, the Hib vaccine, has been available since the 1980s. The antibiotic rifampicin may also be used to prevent the disease among those who have been exposed to the disease and are at high risk. The most important part of treatment involves securing the airway, which is often done by endotracheal intubation. Intravenous antibiotics such as ceftriaxone and possibly vancomycin or clindamycin is then given. Corticosteroids are also typically used. With appropriate treatment, the risk of death among children with the condition is about one percent and among adults is seven percent. With the use of the Hib vaccine, the number of cases of epiglottitis has decreased by more than 95%. Historically, young children were mostly affected, but it is now more common among older children and adults. In the United States, it affects about 1.3 per 100,000 children a year. In adults, between 1 and 4 per 100,000 are affected a year. It occurs more commonly in the developing world.

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Épiglottite

L'épiglottite est un type de laryngite pouvant constituer une urgence vitale chez l'enfant et consistant en un œdème de l'épiglotte obstruant les voies aériennes supérieures. Elles sont le plus souvent infectieuses et le premier germe en cause est l'Haemophilus influenzae. Le terrain est essentiellement l'enfant mais elle peut survenir chez l'adulte. Rarement, elles peuvent être secondaires à une lésion traumatique, thermique ou corrosive.

Stridor

Le stridor est un bruit aigu continu anormal émis lors de la respiration (plutôt inspiratoire qu'expiratoire), dû à un passage anormal de l'air dans les voies aériennes supérieures (larynx le plus souvent, parfois trachée). Chez le nourrisson de moins de six mois, il peut être dû à différentes causes : stridor laryngé congénital essentiel (ou laryngomalacie), l'anomalie la plus fréquente, elle est alors inspiratoire, précoce, isolée, bien tolérée, et spontanément résolutive dans les mois ; angiome sous glottique ; paralysies laryngées ; sténoses laryngées, congénitales ou acquises ; kystes laryngés et juxta-laryngés, rares, diagnostiquées par la fibroscopie nasopharyngée ; œdème du larynx (croup).

Peritonsillar abscess

Peritonsillar abscess (PTA), also known as quinsy, is an accumulation of pus due to an infection behind the tonsil. Symptoms include fever, throat pain, trouble opening the mouth, and a change to the voice. Pain is usually worse on one side. Complications may include blockage of the airway or aspiration pneumonitis. PTA is typically due to infection by a number of types of bacteria. Often it follows streptococcal pharyngitis. They do not typically occur in those who have had a tonsillectomy.

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