Which of the following is the aetiological agent most often associated with Epiglottitis in children -

Ans. is (a > b) Streptococcus pneumoniae In recent days because of vaccination, cases of Epiglottitis due to Haemophilus influenzae type b have gone down drastically and thus change in option from B to A. In the past, epiglottitis was most common in children 2 to 5 years old and was usually caused by the bacterium Haemophilus influenzae type b. Now that most children are vaccinated against Haemophilus influenzae type b, the disease is quite rare and is more common among adults. In adults, and also in children now, it is typically caused by Streptococcus pneumoniae, other streptococci, and staphylococci. Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae (see Etiology) can colonize the pharynges of otherwise healthy children through respiratory transmission from intimate contact. These bacteria may penetrate the mucosal barrier, invading the bloodstream and causing bacteremia and seeding of the epiglottis and surrounding tissues. Bacteremia may also lead to infection of the meninges, skin, lungs, ears, joints, and other structures. Hib infection of the epiglottis leads to acute onset of inflammatory edema, beginning on the lingual surface of the epiglottis where the submucosa is loosely attached. Swelling significantly reduces the airway aperture. Edema rapidly progresses to involve the aryepiglottic folds, the arytenoids, and the entire supraglottic larynx. The tightly bound epithelium on the vocal cords halts edema spread at this level. Frank airway obstruction, aspiration of oropharyngeal secretions, or distal mucous plugging can cause respiratory arrest. Noninfectious inflammation of any of the structures around the epiglottis may also result from thermal or chemical injury or from local trauma, including blunt trauma to the neck.