Epiglottitis in Adults: Symptoms, Causes, and Recovery Guide

Epiglottitis is the inflammation and swelling of the epiglottis, the small, leaf-shaped flap of cartilage at the base of your tongue. Its primary function is to act as a valve, closing over your windpipe (trachea) when you swallow to prevent food and liquid from entering your lungs. When this tissue becomes infected or injured, it can swell rapidly.

In the United Kingdom, the incidence of epiglottitis has decreased significantly since the introduction of the Haemophilus influenzae type b (Hib) vaccine. However, the condition still occurs, particularly in adults who may not have full immunity or in cases caused by other bacteria, viruses, or physical injury to the throat. Because the swelling can potentially block the airway, it is considered a medical priority requiring swift assessment.

Unlike a standard sore throat or pharyngitis, the symptoms of epiglottitis tend to progress quickly and feel significantly more severe. British patients are advised to look out for a cluster of symptoms often referred to as the '4 Ds': Drooling, Dysphagia (difficulty swallowing), Dysphonia (muffled voice), and Distress.

Common signs include:

• Severe sore throat: A throat that feels extremely painful, often worsening rapidly over a few hours.
• High temperature: A fever often exceeding 38°C, accompanied by chills.
• Difficulty swallowing: Pain so intense that the patient may avoid swallowing their own saliva, leading to drooling.
• Muffled voice: Often described as a 'hot potato voice,' as if the person is trying to speak with hot food in their mouth.
• Stridor: A high-pitched, whistling sound when breathing in, which indicates a narrowing of the upper airway.

The most common cause of epiglottitis is a bacterial infection. While Haemophilus influenzae was once the leading cause, NICE (National Institute for Health and Care Excellence) notes that other pathogens are now frequently involved in UK adult cases, including Streptococcus pneumoniae and Staphylococcus aureus.

Other non-infectious causes can include:

• Physical injury: Swallowing a small object or sustaining a direct blow to the throat.
• Thermal burns: Drinking extremely hot liquids or inhaling steam.
• Chemical burns: Inhaling or swallowing corrosive substances.
• Smoking: Inhalation of illicit substances or heavy tobacco use can occasionally irritate the epiglottis to the point of inflammation.

If epiglottitis is suspected, a physical examination in a controlled clinical environment is necessary. Doctors will usually avoid using a tongue depressor to look at the throat, as this can sometimes trigger a spasm that closes the airway entirely. Instead, a specialist may use a nasendoscopy—a thin, flexible tube with a camera passed through the nose—to view the epiglottis safely.

Once diagnosed, treatment is typically managed in a hospital setting. The priority is ensuring the airway remains open. Patients may be given oxygen via a mask. If the infection is bacterial, intravenous antibiotics are administered immediately. Steroids may also be used to reduce inflammation. Most adults recover fully within a week if the condition is caught early and treated appropriately.

If you have a sore throat that is uncomfortable but you are still able to swallow, breathe easily, and speak clearly, you may wish to speak to a GP online. An online consultation is a convenient way to rule out other common ENT concerns such as tonsillitis or viral pharyngitis.

A UK online doctor can review your symptoms, provide advice on pain management (such as the use of paracetamol or ibuprofen), and issue a sick note if you are too unwell to work. However, if the doctor suspects your symptoms are progressing toward epiglottitis, they will advise you to attend the nearest Accident and Emergency department immediately. Online doctors provide a vital first port of call for triaging respiratory symptoms and ensuring you receive the correct level of care.

The most effective way to prevent the most dangerous form of bacterial epiglottitis is through the NHS vaccination programme. The Hib vaccine is routinely given to infants in the UK as part of the '6-in-1' vaccine. If you are unsure of your vaccination status, or if you are travelling to regions where Hib is more prevalent, you should discuss this with a healthcare professional.

General hygiene, such as regular handwashing and avoiding close contact with individuals suffering from acute respiratory infections, also reduces the risk of contracting the various bacteria that can cause throat inflammation.