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Tests and diagnosis
By Mayo Clinic staffIf the medical team suspects epiglottitis, the first priority is to ensure that your or your child's airway is open and that enough oxygen is getting through.
Initial test
A pulse oximeter is a device that estimates blood oxygen levels. This device:
- Clips onto a finger
- Measures an estimation of the saturation of oxygen in your blood
If oxygen saturation levels drop too low, you or your child may need help breathing.
Tests after stabilizing breathing
- Throat examination. Using a flexible fiber-optic-lighted tube, the doctor may look down your or your child's throat to see what's causing the symptoms. A local anesthetic can help relieve any discomfort.
- Chest or neck X-ray. Because of the danger of sudden breathing problems, children may have X-rays taken at their bedside rather than in the radiology department — but only after the airway is protected. With epiglottitis, the X-ray may reveal what looks like a thumbprint in the neck, an indication of an enlarged epiglottis.
- Throat culture and blood tests. For the culture, the epiglottis is wiped with a cotton swab and the tissue sample is checked for Hib. Blood cultures are usually taken because bacteremia — a severe bloodstream infection — may accompany epiglottitis.
References
- Epiglottitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec08/ch090/ch090l.html. Accessed May 17, 2012.
- Is your child protected against Hib? Centers for Disease Control and Prevention. http://www.cdc.gov/Features/HibDisease/. Accessed May 17, 2012.
- Haemophilus influenzae type b (Hib) vaccine. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hib.pdf. Accessed May 19, 2012.
- Hay WW, et al. Current Diagnosis & Treatment: Pediatrics. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6582059. Accessed May 17, 2012.
- Grover C. Thumb sign of epiglottitis. The New England Journal of Medicine. 2011;365:447.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9097038. Accessed May 17, 2012.
- Lalwani AK. Current Diagnosis & Treatment in Otolaryngology - Head & Neck Surgery. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=55768949. Accessed May 17, 2012.
- Kavanagh KR, et al. Traumatic epiglottitis after foreign body ingestion. Journal of Pediatric Otorhinolaryngology. 2008;72:901.
- Shah RK, et al. Epiglottitis in the United States: National trends, variances, prognosis and management. Laryngoscope. 2010;120:1256.
- Valdez-Lowe C, et al. Pulse oximetry in adults. American Journal of Nursing. 2009;109:52.
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