When epiglottitis is suspected, the immediate priority is to confirm the diagnosis swiftly and accurately to begin appropriate treatment. This starts with ensuring the patient has a stable airway and is receiving sufficient oxygen. Medical professionals will closely monitor breathing patterns and blood oxygen saturation levels right away. If oxygen levels are dangerously low, immediate breathing assistance will be provided.
Diagnostic Procedures Following Airway Stabilization
Once the patient’s breathing is stable, a series of diagnostic tests are conducted to confirm epiglottitis and determine the best course of action. These tests are crucial for differentiating epiglottitis from other conditions that may present with similar symptoms.
Laryngoscopy or Throat Exam
A key diagnostic tool is a laryngoscopy, or throat exam. Typically performed by an otolaryngologist or emergency medicine physician, this procedure utilizes a flexible, fiber-optic lighted tube. The tube is gently inserted through the nose to allow direct visualization of the throat and, specifically, the epiglottis. This allows the healthcare provider to directly observe any swelling, redness, or inflammation that is characteristic of epiglottitis. To enhance patient comfort during this procedure, a numbing spray is usually applied to the nasal passages. In some instances, particularly in children or cases with severe airway compromise, this examination may be cautiously conducted in an operating room where immediate airway intervention, such as intubation, can be performed if needed.
Chest and Neck X-rays
While not always necessary to definitively diagnose epiglottitis, chest and neck X-rays can provide valuable supporting evidence. In cases of epiglottitis, an X-ray of the neck might reveal a distinctive “thumbprint sign.” This radiographic finding refers to the appearance of the enlarged and swollen epiglottis, which resembles the shape of a thumb on the X-ray image. X-rays also help to rule out other potential causes of respiratory distress and assess the overall condition of the airway and surrounding structures.
Throat Culture and Blood Tests
Following the stabilization of breathing, throat cultures and blood tests are typically performed. For a throat culture, a healthcare professional will gently swab the surface of the epiglottis to collect a tissue sample. This sample is then sent to a laboratory to identify any bacterial pathogens, most notably Haemophilus influenzae type b (Hib), which was historically a leading cause of epiglottitis. Blood cultures are also drawn to detect the presence of bacteremia, a bloodstream infection. Bacteremia is frequently associated with epiglottitis and its identification can further support the diagnosis and guide antibiotic therapy.
These diagnostic steps are crucial in confirming epiglottitis and enabling prompt and effective treatment, ultimately aimed at resolving the infection and ensuring a full recovery.
