Epiglottitis is a serious condition that can affect children and adults. In children, epiglottitis can be life-threatening and usually manifests between 2 and 6 years. In adults, it is more likely to affect men than women. Earlier there were more number of pediatric epiglottitis cases. But with the introduction of the HIB vaccine, cases of children being affected by this condition has reduced. This condition occurs when the flap of cartilage found at the back of the tongue (epiglottis) swells can causes respiratory distress.
The epiglottis serves to keep food from going into the trachea while swallowing. An inflamed epiglottis can result in swallowing problems and difficulty in breathing. The patient suffers fever and chills and may develop a bluish skin coloring or cyanosis. If the airways become totally obstructed, it can be fatal. Sore throat, difficulty in speaking and difficulty in swallowing and breathing are typical symptoms of epiglottitis that occur within a few hours. Persons affected by this condition tend to lean forward to breathe and appear restless.
Epiglottitis is believed to be caused by virus such as Streptococcus pneumoniae, Haemophilus parainfluenzae, varicella-zoster, herpes simplex virus type 1 and Staphylococcus aureus. Any damage to the epiglottis can also cause this condition. While mild cases of epiglottitis manifest as sore throat and pain while swallowing, acute cases can suffer severe respiratory distress or even a respiratory arrest.
Physical examination and study of medical history is the first step towards diagnosing epiglottitis. X-ray of the neck and blood tests are also conducted. If there is severe discomfort and labored breathing, hospitalization may be necessary. Humified oxygen helps alleviate some of the distress while intravenous fluids keep the patient well hydrated. Antibiotics and corticosteroids are used to treat the condition. Intravenous (IV) antibiotics are administered to treat the infection.
Fungal Throat Infection is also referred to as oral thrush. It is an infection caused by the yeast fungus Candida albicans. In most people, the presence of Candida in the oral cavity is not uncommon. It is only when there is a change that favors the growth of candida that a fungal throat infection develops. Conditions such as diabetes, AIDS and malnutrition can trigger this change.
Persons suffering from oral thrush will notice whitish spots in the mouth. There may be burning or bleeding. It can lead to fungal infection of the throat and consequently nausea and difficulty in swallowing. A throat culture helps in identifying the micro organisms that cause the infection in the throat. It could reveal epiglottis, strep throat, pharyngitis or diphtheria. Anti fungal drugs such as nystatin, amphotericin or miconazole are used to treat oral thrush.
Anaphylaxis is a hypersensitive reaction due to contact through allergens. These allergens induce an immediate immune response that is life threatening in most occasions. Anaphylactic reactions produce various clinical symptoms such as urticaria, respiratory congestion and gastrointestinal disturbances. Anaphylactic response is caused by certain type of compounds which may include proteins, pollen, venom, hormones and also some food extracts. The immunoglobulin E or IgE is responsible for the onset of anaphylactic reaction when exposed to an allergen.
Mechanism of anaphylactic reaction
A series of reactions take place in the body when anaphylaxis is triggered. The IgE which has a half-life of two days, binds to the fragment crystallizable or FC receptor part of the basophils and mast cells. This process is activated when the person comes in contact with an allergen which in turn mediates cellular de granulation and their release of biogenic amines such as histamine and serotonin. The effects of these biogenic amines may include the smooth muscles which generally constrict at the bronchiolar region and broncho capillary venules. It also causes the arteriole dilation.
Anaphylactic responses are of different types and are associated with allergen sources of different kinds such as pollen, food, insects and also some drugs. It happens because of the antigen contact to which the patient had been previously exposed. This type of antigen is also called an allergen. Systemic anaphylaxis is a serious condition in which the mast cells of the connective tissue become activated resulting in dangerous effects such as airway obstruction, swelling of the epiglottis and ultimately suffocation. Systemic anaphylaxis proceeds into another condition called anaphylactic shock which happens because of suffocation induced by the respective allergen. In addition to these, anaphylaxis may also result because of extreme physical exercise. This condition is also called exercise induced urticaria. Allergies to food like eggs and milk are common among infants. Other than these, underlying conditions such as hay fever, asthma and eczema may also induce anaphylaxis if untreated.
Anaphylactic shock is widely reported in people after consuming foods such as peanuts and Brazil nuts. Such food products induce the anaphylactic reaction in an instant causing severe discomfort and sometimes death. Many people also experience anaphylactic reactions because of penicillin administration. Some reactions of anaphylaxis also include excess production of mucous in the mouth, nose and throat. Atopic patients are highly susceptible to anaphylaxis. Patients having an underlying atopic condition produce high amount of IgE antibodies and hence they must be monitored carefully.
Diagnosis of Anaphylaxis
Anaphylactic reaction is diagnosed based on clinical symptoms such as skin rash (insect bites), hoarse voice, chest congestion, breathing difficulty, diarrhea, vomiting and abdominal cramps. Identification of the source is the predominant factor in the diagnosis of anaphylactic reactions. Thorough examination of the cause with immediate life saving measures must be done. Anaphylaxis can be fatal if not managed properly.
Avoid foods that induce the condition. In the case of anaphylactic reaction, medical attention must be sought immediately. Oral medications such as Benadryl or diphenhydramine are given. EpiPen or injectable epinephrine is the drug of choice to control the anaphylactic reaction. Intravenous antihistamine drugs and oral steroids are given for a period of time to prevent the reoccurrence of the anaphylactic reactions.
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Bibliography / Reference
Collection of Pages - Last revised Date: January 25, 2022