Epiglottitis

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.

Wheezing

Wheezing is a characteristic high pitched whistling sound made while breathing, a primary symptom of a chronic respiratory disease - Asthma. It is not uncommon in those with respiratory allergies, especially during the hay fever season. Sometimes, other respiratory infections could be accompanied by mild wheezing, especially when acute Bronchitis is experienced. It is also noticed in those with heart failure and Chronic Obstructive Pulmonary Disease COPD. While most commonly wheezing occurs during breathing out, it can sometimes also be related to breathing in.

Causes of Wheezing

Narrowing of airways results in breathing difficulty and wheezing. There could be several causes for narrowing of airways including inflammation from asthma, infection, allergic reaction or a physical obstruction such as tumor or foreign body inhalation. Among the possible causes of wheezing include allergies, insect bite or medication or pollen, pet dander, dust, foods, Bronchiolitis, bronchitis, childhood asthma, epiglottitis, GERD, heart failure, lung cancer, pneumonia, sleep apnea, smoking and vocal cord dysfunction.

Respiratory Syncytial Virus (RSV) Infection is also known as Bronchiolitis - inflammation of the bronchioles which in turn refer to the the narrow airways which branch from bronchi to the air sacs called as alveoli. This RSV infection largely affects infants and children.

To determine the cause of wheezing, your doctor will ask questions about any symptoms that triggers it. If you have no history of lung disease and develop wheezing after eating a certain food or in a certain season, respiratory allergy is suspected. The doctor checks the lungs with a stethoscope to find out where the wheezing is and how bad it is. During a first time evaluation, the doctor performs a spirometry - breathing test, and also a chest X ray.

Sometimes other blood tests and procedures become necessary depending upon the health condition. In case it is allergic wheezing, then a variety of tests to determine the allergies including dermatological examinations are done.

Wheezing problems

Wheezing is accompanied by difficult breathing, rapid breathing and briefly bluish skin color. Emergency care must be sought if wheezing begins suddenly after being stung by a bee, while taking medication, or eating an allergy-causing food or after choking on a small object or food.

Wheezing in infants

In case of a baby, wheezing could be due to cold or problematic asthma. But it is not always clear if the infant has asthma. It is essential to get a firm diagnosis and make sure that the child gets treated for any breathing problems. In some infants, Bronchiolitis could occur due to a viral infection. The airways swell making breathing difficult. As the airway of an infant is small, infants are easily affected. Wheezing could result due to Bronchiolitis, which may develop into asthma in later life. Otherwise a child could be born with a tendency to wheeze and therefore could be prone to bronchiolitis and asthma. Less common reasons for wheezing in infants include inhalation of a foreign object or piece of food into the lungs, premature birth, insufficiently developed airways and cystic fibrosis.

Treatment options

A variety of treatments are available to help alleviate wheezing. However, regular monitoring by a doctor is a must, especially if the patient has asthma, chronic allergies, severe bronchitis, emphysema or chronic obstructive pulmonary disease. In some, wheezing can be relieved by certain medications or by using an inhaler. Some might need insertion of a breathing tube into the throat. The doctor may recommend some or all of the following to reduce inflammation and open up the airways obstructing breathing to stop wheezing:

• A bronchodilator inhaler, which can act fast to dilate constricted airways.
  
• An inhaled Corticosteroid
  
• A long-acting bronchodilator and Corticosteroid combination
  
• A controller pill for asthma to reduce airway inflammation
  
• A non-sedating antihistamine pill or a prescription nasal spray for nasal allergies, which are available over the counter.

Self-care measures to ease wheezing

Moisturize the air by either using a humidifier or a steamy shower or just sit in the bathroom with the door closed while running a hot shower. This is simply because moist air can help relieve mild wheezing in some cases.

Drinking fluids can relax the airway and loosen up sticky mucus in the throat.

Active or passive smoking can worsen a cough and hence it is best to avoid tobacco.

Emergency

Normally, mild wheezing that accompanies bronchitis disappears when the infection subsides. But in case of breathing difficulty, she needs to rush to the doctor who can administer the following:

• A shot of epinephrine to open up the clogged respiratory passages.
  
• Oxygen
  
• Frequent nebulizer to ease breathing
  
• A mechanical ventilator to help you breathe

It is for the doctor to determine the cause of wheezing and then treat the patient for the specific cause.

Laryngitis

Laryngitis is a condition where the larynx is swollen thereby resulting in hoarse voice. This happens when the vocal chords are inflamed or infected. Laryngitis can be caused by GERD, pneumonia, allergy or bacterial infection. Laryngitis is often accompanied by respiratory infection and swollen lymph nodes. Other symptoms are sore throat, difficulty in swallowing, fever and cough. Laryngitis can worsen into Croup or epiglottitis. Laryngitis is treated with antibiotics, decongestant and painkillers. Laryngoscopy is a medical procedure that is used to obtain a view of the vocal folds and the glottis.