Acute subglottic laryngitis (ASL), sometimes called pseudo-croup, is an infection that is usually seen in children and has a higher prevalence in boys. Most cases are reported at around one and a half years of age. In some literature, infection is only considered to be ASL if the causative organism is a virus [1]. ASL can, however, be bacterial or fungal. Furthermore, other sources of literature distinguish pseudo-croup from croup based on the causative organism, with croup being caused by the Corynebacterium diphtheriae.

The most frequently implicated virus is the parainfluenza virus. Initial viral infection can be followed by bacterial superinfection [2] [3]. The rate of occurrence of ASL may be higher in certain seasons, namely autumn and winter [1]. There are several modes of infection, for example, through airborne organisms, blood or trauma [4]. Some cases of ASL are preceded by other respiratory tract infections. Precipitating factors of ASL include infections, both local and systemic, hypersensitivity reactions, air pollution, cigarette smoke, and foreign bodies.

Symptoms are mainly due to the primary characteristic of ASL, which is narrowing of the trachea in the subglottic region due to inflammation resulting in edema. The extent to which the trachea narrows determines the severity of symptoms. Narrowing of the trachea is made more likely if there is a history of asthma, gastroesophageal reflux disease (GERD), trauma, or preexisting scarring or stenosis [2]. The onset of ASL is rapid and often occurs at night. It is also acute and self-limiting; thus treatment given is supportive.

Respiratory manifestations of the condition include dyspnea, cough, stridor, and hoarseness. Constitutional symptoms may be present, such as fever, cervical lymphadenopathy, loss of appetite, weakness, and restlessness. Cyanosis may also occur due to lack of oxygen. In a few cases, the condition may be life-threatening.

• Fever

  From WikiLectures Staphylococcal infections including toxic shock syndrome Infections due to group B streptococci, enterococci, and viridans streptococci Pneumococcal infections Scarlet fever and toxic shock syndrome Erysipelas, cellulitis and necrotizing [wikilectures.eu]

  Fever and chills 2. headache 3. pain of the throat Signs 1. enlarged tonsils 2.red & white cover, white cover of the tongue, 3. lymphadenopathy CENTOR criteria! [quizlet.com]

  Apart from sore throat, symptoms of this include fatigue, fever, inflammation of the throat, headache, and vomiting. Treatment involves reducing fever with antipyretics before any medication. [health.ccm.net]

  Constitutional symptoms may be present, such as fever, cervical lymphadenopathy, loss of appetite, weakness, and restlessness. Cyanosis may also occur due to lack of oxygen. In a few cases, the condition may be life-threatening. [symptoma.com]

  Medicines Symptoms include fever and a sore throat. Ease the symptoms by administering antipyretics and/or analgesics (paracetamol, ibuprofen, naproxen). [hus.fi]

• Falling

  It is the most common cause of upper respiratory distress in infants and young children which usually occurs in late fall to early winter 3. [radiopaedia.org]

  Make sure the child is not in danger of falling! Cool ambient air Cool air reduces swelling of the mucous membranes. Make sure the bedroom temperature is comfortably cool. Medicines Symptoms include fever and a sore throat. [hus.fi]

  As the infant inhales, the soft larynx falls together, narrowing the inlet and stridor results 3. Swallowing is unaffected Direct examination of laryngmalacia 1. Larynx fall together with inhalation 2. Subglottic area is normal 3. [brainscape.com]

  At the time the highest incidence of laryngitis (in the fall and early spring), it is appropriate to increase the consumption of fruits rich in vitamins or vitamin preparations reap the benefits as a dietary supplement. [sicknessfinder.com]

  The incidence of croup is higher in boys; it occurs most commonly in the late fall and winter but can occur throughout the year. Recurrences are frequent from 3-6 yr of age and decrease with growth of the airway. [clinicalgate.com]

• Malaise

  Type 3 - Recurrent aphtous eczema Recurrent aphtous stomatitis gross small aphtas Etiology of Recurrent aphtous stomatitis Unknown Findings in Recurrent aphtous stomatitis Higher TNF Symtpoms of Recurrent aphtous stomatitis burning pain malaise fever [quizlet.com]

  A Streptococcus a patient may present with a sore throat and general malaise. You’ll then have the complete recipe in your recipe box. Hey I’ve been really worried about listeria this whole pregnancy especially. [elmemesser.eu]

  ACUTE LARYNGITIS (SIMPLE)- SYMPTOMS• Hoarseness of voice• Discomfort• Pain• Instant paroxysmal cough• General cold• Dryness of throat• Malaise• fever 5. [slideshare.net]

  Fever & malaise. 4. There may be respiratory obstruction & stridor in severe cases. 5. [slideplayer.com]

  Fatigue and malaise. Chronic laryngitis By definition, any patient with symptoms of acute laryngitis persisting for longer than three weeks should be deemed to have chronic laryngitis. [patient.info]

• High Fever

  Acute Epiglottitis (Supraglottitis) This dramatic, potentially lethal condition is characterized by an acute rapidly progressive and potentially fulminating course of high fever, sore throat, dyspnea, and rapidly progressing respiratory obstruction. [clinicalgate.com]

  The patient then becomes seriously ill with high fever, toxicity and respiratory distress. External Compression. [aafp.org]

  The patient often has a high fever and appears quite toxic. This may make the clinician lean toward a clinical diagnosis of epiglottitis. [ahcmedia.com]

• Foreign Body Aspiration

  Foreign Body. Foreign body aspiration is a common cause of acute stridor. The peak incidence is between one and two years of age. The foreign body is usually food. A history of aspiration or choking can be obtained in 90 percent of cases. [aafp.org]

  General imaging differential considerations include: tracheal foreign body aspiration esophageal foreign body angioneurotic edema epiglottic cysts epiglottitis enlargement of the epiglottis and aryepiglottic folds thumb sign (or omega sign ) usually older [radiopaedia.org]

  The differential diagnosis of viral croup includes other members of the croup syndromes especially spasmotic croup, diphtheria, measles, retropharyngeal abscess, foreign body aspiration, extrinsic airway compression, intraluminal laryngeal obstruction [virtualpediatrichospital.org]

• Cough

  and irritant induced cough; Pharmacologic management; Unexplained cough; Cough in the pediatric population; and Rhinogenic laryngitis, cough and the unified airway; among others. [books.google.com]

  It predominantly occurs in children and presents with difficulty in breathing, voice changes, and a barking cough. [symptoma.com]

  Symptoms of laryngitis include violent cough and hoarseness, episodes of an asphyxiating cough, breathing discomfort, sudden onset of coughing (usually at night). [health.ccm.net]

  Symptoms hoarse voice hollow, barking cough breathing becomes noisy, difficulty in breathing which is made worse by crying onset usually during the night the most difficult phase lasts 2 to 3 days, cough may persist for over a week fever during the first [hus.fi]

  A viral Coughs are also referred to as chesty coughs, with the related symptoms of. Radiographic imaging studies in pediatric chronic sinusitis: 1. Sore throats are normally caused by either a viral or bacterial infection. [elmemesser.eu]

• Hoarseness

  Diagnosis Diagnosis is usually made by learning the history of a cold followed by hoarseness. The throat usually appears red and somewhat swollen. [medical-dictionary.thefreedictionary.com]

  Talking too much, screaming, constantly clearing your throat, or smoking can make you hoarse. They can also lead to problems such as nodules, polyps, and sores on the vocal cords. [icdlist.com]

  As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become almost undetectable. Laryngitis may be short-lived (acute) or long lasting (chronic). [mayoclinic.org]

  "Hoarseness in Adults". Am Fam Physician. 11 (11): 720–728. PMID 29431404. ^ a b Dominguez, L. M.; Simpson, C. B. (December 2015). "Viral laryngitis". [en.wikipedia.org]

• Stridor

  Stridor is a sign of upper airway obstruction. In children, laryngomalacia is the most common cause of chronic stridor, while croup is the most common cause of acute stridor. [aafp.org]

  A congenital form results in neonatal stridor or laryngotracheitis, often requiring tracheotomy but resolving with age. [translate.academic.ru]

  Stridor ceases if the larynx is held open with laryngoscope Most infants cease to have the stridor by the 12th to 15th month Can be associated with a 2nd upper airway abnormality Disorder of the trachea due to lack of rigidity of the tracheal cartilages [brainscape.com]

  Once stridor develops, you may only have minutes to act. [atsu.edu]

  Intermittent respiratory stridor then occurs (SOUND). As obstruction increases, the stridor increases, actually becoming continuous, with associated hypoventilation, hypercapnea, and hypoxia. [virtualpediatrichospital.org]

• Dyspnea

  The most frequent causes of dyspnea were acute subglottic laryngitis (8 cases) and laryngomalacia (4 cases). Seven cases had difficulty in decannulation. [jstage.jst.go.jp]

  Respiratory manifestations of the condition include dyspnea, cough, stridor, and hoarseness. Constitutional symptoms may be present, such as fever, cervical lymphadenopathy, loss of appetite, weakness, and restlessness. [symptoma.com]

  Ordinarily there is no dyspnea, as the trachea will allow of great encroachment on the caliber of its lumen without interfering with the normal air current; but in very severe cases there may be slight dyspnea. [operatingmicroscopes.com]

  Most young patients with croup progress only as far as stridor and slight dyspnea before they start to recover. Physical examination can reveal a hoarse voice, coryza, normal to moderately inflamed pharynx, and a slightly increased respiratory rate. [clinicalgate.com]

  The disease begins with symptoms similar to those of subglottic laryngitis, but the dyspnea does not disappear after a few hours. Except for inspiratory dyspnoea, mixed inspirator-expiratory dyspnoea may develop. [czytelniamedyczna.pl]

• Inspiratory Stridor

  Clinically it presents with protracted barking cough and inspiratory stridor due to mucosal edema resulting in tracheal narrowing. Plain radiograph Plain radiographs are not always required, as the diagnosis is often made clinically. [radiopaedia.org]

  Viral croup is diagnosed by hoarseness, barking cough, and inspiratory stridor and retractions, which indicate airway obstruction (Table AI-3). [atsu.edu]

  Generally, an inspiratory stridor suggests airway obstruction above the glottis while an expiratory stridor is indicative of obstruction in the lower trachea. A biphasic stridor suggests a glottic or subglottic lesion. [aafp.org]

  Stridor is a harsh, high-pitched respiratory sound, which is usually inspiratory but can be biphasic and is produced by turbulent airflow; it is not a diagnosis but a sign of upper airway obstruction ( Chapter 366 ). [clinicalgate.com]

  The illness is generally quite mild with sore throat, hoarseness, cough, and possibly mild inspiratory stridor. Respiratory distress is rare with the exception of young infants. [virtualpediatrichospital.org]

• Vomiting

  Apart from sore throat, symptoms of this include fatigue, fever, inflammation of the throat, headache, and vomiting. Treatment involves reducing fever with antipyretics before any medication. [health.ccm.net]

  ANGIONEUROTIC OEDEMA• May be allergic, non allergic OR hereditary and non hereditary• Recurrent attacks of local swelling in various parts of the body: face, larynx, limbs, buttocks• Death occurs because of the edema of the larynx• Colic, nausea, vomiting [slideshare.net]

  When those bites go beyond a bothersome itch it’s important to know what can cause abdominal pain diarrhea fever headache lack of appetite muscle aches nausea rash swollen throat and lymph nodes and vomiting. [elmemesser.eu]

  The symptoms of GERD in children, depending on their age, include vomiting, a decreased food intake followed by failure to thrive, sucking disorders and dysphagia, abdominal pains, retrosternal pains, oeso-phagitis, and many others associated with the [czytelniamedyczna.pl]

  Sometimes there is vomiting and great nervous excitement, even convulsions. [operatingmicroscopes.com]

• Nausea

  I was experiencing terrible viral throat infection white spots tonsils sore throat jaw sore fever migraine headaches fatigue insomnia and nausea. [elmemesser.eu]

  ANGIONEUROTIC OEDEMA• May be allergic, non allergic OR hereditary and non hereditary• Recurrent attacks of local swelling in various parts of the body: face, larynx, limbs, buttocks• Death occurs because of the edema of the larynx• Colic, nausea, vomiting [slideshare.net]

• Failure to Thrive

  The symptoms of GERD in children, depending on their age, include vomiting, a decreased food intake followed by failure to thrive, sucking disorders and dysphagia, abdominal pains, retrosternal pains, oeso-phagitis, and many others associated with the [czytelniamedyczna.pl]

• Cyanosis

  Cyanosis may also occur due to lack of oxygen. In a few cases, the condition may be life-threatening. The diagnosis of acute subglottic laryngitis is made via a clinical examination, taking into account both history and physical examination. [symptoma.com]

  A considerable degree of face cyanosis can occur. Body Temperature is slightly elevated, and the general condition is not heavily disturbed. [laryngitisknowledgebase.com]

  Blue lips Assessment Questionnaire; Why: certain causes of cyanosis are limited to children such as acute epiglottitis, croup and acute subglottic laryngitis. A disorder simulating croup; especially acute subglottic laryngitis .. [acronymattic.com]

  Degree of cyanosis 7. Degree of retraction 8. Overall fatigue Indicate the need to support (croup) 1. RR over 40 2. PR over 160 3. [brainscape.com]

  Pallor or cyanosis late danger signs B. [slideplayer.com]

• Erythema

  […] multiforme, Stevens-Johnson syndrome, erythema nodosum Fever and its treatment strategy Fever of unknown origin - FUO (etiology and work-up) Differential diagnosis of febrile illness in tropical and subtropical areas Differential diagnosis of maculopapular [wikilectures.eu]

  Direct examination reveals diffuse laryngeal erythema and edema and vascular engorgement of the vocal folds. [atsu.edu]

  ACUTE LARYNGITIS (SIMPLE)- SIGNS• Erythema and edema of epiglottis, aryepiglottic folds, arytenoids and ventricular bands• Vocal cords appear normal in early stages• In later stages congestion and swelling increases, vocal cords become red and swollen [slideshare.net]

  The physical examination may show some minor erythema and minimal edema of the supraglottic structures. Treatment includes resting the voice and inhalation of humidified air. Antibiotics are indicated if diphtheria is thought to be the cause. [virtualpediatrichospital.org]

  Gross findings- Catharral stomatitis erythema (redness) of the mucosa small oedema while acute turns into chronic - blue-red dry mucous membrane Treatment of Catharral stomatitis elimination of irritating factors disinfectants locally vitamins B, C supplementation [quizlet.com]

• Agitation

  Croup is characterized by a "barking" cough, stridor, hoarseness, and difficulty breathing which usually worsens at night. [1] The "barking" cough is often described as resembling the call of a seal or sea lion. [4] The stridor is worsened by agitation [en.wikipedia.org]

  The stridor is usually aggravated by respiratory tract infections and agitation. 11 Bacterial Tracheitis. [aafp.org]

  If a child with medium obstruction becomes agitated or tired, it is a sign of progression to the severe form;- severe, score > 7: stridor and ample retraction, also present in repose, cyanosis, tachycardia, convulsion or obnubilation, loss of interest [essaymonster.net]

  Agitation and crying greatly aggravate the symptoms and signs. The child may prefer to sit up in bed or be held upright. Older children usually are not seriously ill. Other family members might have mild respiratory illnesses with laryngitis. [clinicalgate.com]

  Agitation and/or altered consciousness B. Rising pulse and respiratory rate, paradoxical pulse • Danger signs A. Pallor or cyanosis late danger signs B. [slideplayer.com]

• Screaming

  Talking too much, screaming, constantly clearing your throat, or smoking can make you hoarse. They can also lead to problems such as nodules, polyps, and sores on the vocal cords. [icdlist.com]

  Trauma: Trauma due to voice misuse - screaming, yelling, loud singing. Trauma due to excessive voice use - more common in certain professions such as teachers, actors and singers. Coughing. Penetrating or blunt external force. [patient.info]

  Trauma [ edit ] Often due to excessive use of the vocal folds such as excessive yelling, screaming, or singing. [en.wikipedia.org]

• Seizure

  That true spasm of the laryngeal muscle is a prominent factor in these seizures is asserted by Rilliet and Benitez,' D'Espine and Picot, J. [operatingmicroscopes.com]

• Excitement

  The exciting cause is practically the same as in the previous class. [operatingmicroscopes.com]

The diagnosis of acute subglottic laryngitis is made via a clinical examination, taking into account both history and physical examination. Laboratory studies are not routinely carried out. If there is pus, this can be cultured, and sensitivity determined before antibiotics are administered [5]. Nose and throat swabs may also be taken. A complete blood count (CBC) may be requested if the infection is thought to be bacterial in origin. Other possible laboratory tests are PCR (polymerase chain reaction), lateral flow tests, and immunoprecipitation.

Imaging modalities include laryngoscopy, although this is not mandatory. Laryngoscopy allows visualization of the inflamed airways and may reveal distortion in the symmetry and movement of the same [6]. Laryngoscopy is often done by a specialist. General practitioners may use indirect laryngoscopy. An additional imaging method is videostroboscopy [7]. This is used when presenting symptoms and laryngoscopic results are mismatched [8].

Clinical features, diagnosis and treatment. 61. Acute stenosis laryngo-tracheo-bronchitis. Etiology, diagnosis and treatment. 62. Acute subglottic laryngitis. Etiology, clinical features, diagnosis and treatment. 98. Glottic angina. [acronymattic.com]

1.Breathlessness 2.cough 3. unchanged voice Acute subglottic laryngitis Etiology Viral allergic GERD bacterial Acute subglottic laryngitis treatment Treatment in hospital! [quizlet.com]

Treatment of atrophic laryngitis in adults require treatment of the mucosa with the use of aerosol products, which include chymotrypsin. [lesouffleclavie.com]

– In the event of treatment longer than 10 days, decrease doses gradually to avoid adrenal gland failure. – Pregnancy : no contra-indication – Breast-feeding : no contra-indication – Foetal lung maturation: • after 34 weeks of gestation, corticosteroid [medicalguidelines.msf.org]

Croup is usually self-limiting and has a good overall long-term prognosis. [radiopaedia.org]

Rarely, in severe infections such as those with herpes viruses, laryngeal erosion and necrosis may occur. [ 1 ] Prognosis In acute laryngitis, the prognosis is usually excellent. [patient.info]

When properly conducted complex treatment, the prognosis is quite favorable. Abscess of the larynx may develop due to injury of the mucosa and entering into the wound infection, or occur as a complication of phlegmonous laryngitis. [lesouffleclavie.com]

Prognosis Prognosis for laryngitis is excellent. Recovery is complete, and usually occurs within a week's time. Prevention Prevention of laryngitis is the same as for any upper respiratory infections. [medical-dictionary.thefreedictionary.com]

Prognosis. This is a disease of rapid development. It runs a short course of four or five days, the extent and severity of the symptoms varying largely. [operatingmicroscopes.com]

Conclusions.Assessing viral etiology of laryngitis allows us to conclude specific peculiarities between etiological, clinical and demographic spread.INTRODUCTION The subglottic obstructive acute laryngitis of the infant and small child has an almost exclusively [essaymonster.net]

They have been divided into the following groups: Group A--196 children with diseases of unknown etiology; Group B--20 children with identified viral infections; and Group C--68 children with allergic reactions. [ncbi.nlm.nih.gov]

Etiology, diagnosis and treatment. 62. Acute subglottic laryngitis. Etiology, clinical features, diagnosis and treatment. 98. Glottic angina. Etiology, clinical features, diagnosis and treatment. 99. [acronymattic.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

[…] the detection of the viruses responsible of the subglottic obstructive acute laryngitis in children and the establishment of clinical-etiological and epidemiological correlations. Material and method. [essaymonster.net]

[…] encephalitides Dengue fever, chikungunya and yellow fever Epidemiologiy of viral hepatitis including prevention and prophylaxis Symptoms, signs and laboratory features of viral hepatitis Liver injury in infectious diseases (excluding viral hepatitis) Epidemiologic [wikilectures.eu]

Covered by the phlegm Symptoms 1.Cough 2.hoarseness Acute laryngitis treatment Inhalatory steroids antibiotics mucolytics Acute epiglottitis Bacterial Inflammatory oedema of the epiglottis leading to abscess Acute epiglottitis epidemiology Disease of [quizlet.com]

An epidemiological study on 5—8-year-old children. Eur J Pediatr. 158; 3: 253—257. http://dx.doi.org/10.1007/s004310051062 ; PMid:10094451 6. Sherman CB, Tosteson TD, Tager IB et al. 1990. Early childhood predictors of asthma. [med-expert.com.ua]

Epidemiology Accurate figures regarding acute laryngitis are not available, as the condition often goes unreported. [patient.info]

The basic pathophysiology is inflammation of the mucosa lining the vocal folds and larynx. If infection is involved, white cells aggregate to remove infectious material from the area. [patient.info]

The most common bacteria implicated are Staphylococcus aureus, Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis. [4] Pathophysiology [ edit ] The viral infection that causes croup leads to swelling of the larynx, trachea, and [en.wikipedia.org]

[…] cellulitis and necrotizing fasciitis Streptococcal tonsillopharyngitis Diphtheria and differential diagnosis of acute tonsillopharyngitis Listerial infections Diseases caused by food-borne enterotoxins ("food poisoning") and botulism Tetanus including prevention [wikilectures.eu]

Immunological and serological determinations, as well as lung function tests markedly facilitate the identification of etiologic factors in ASL and are of considerable help in planning a therapy and preventing any relapse of the disease. [ncbi.nlm.nih.gov]

Prevention Prevention of laryngitis is the same as for any upper respiratory infections. [medical-dictionary.thefreedictionary.com]

PREVENTION OF LARYNGITIS IN ADULTS AND CHILDREN To prevent the development of laryngitis, it is necessary to treat inflammatory diseases (tonsillitis, sinusitis etc.). [lesouffleclavie.com]

Prevention To prevent dryness or irritation to your vocal cords: Don't smoke, and avoid secondhand smoke. Smoke dries your throat and irritates your vocal cords. Limit alcohol and caffeine. These cause you to lose total body water. [mayoclinic.org]

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2. Cherry JD. Croup. N Engl J Med. 2008;358(4):384–391.
3. Rosekrans JA. Viral croup: current diagnosis and treatment. Mayo Clin Proc. 1998;73(11):1102–1107.
4. Wood JM, Athanasiadis T, Allen J. Laryngitis. BMJ. 2014;349:g5827.
5. Vaughan CW. Current concepts in otolaryngology: diagnosis and treatment of organic voice disorders. N Engl J Med. 1982;307(14):863-866.
6. Ng ML, Gilbert HR, Lerman JW. Some aerodynamic and acoustic characteristics of acute laryngitis. J Voice. 1997;11(3):356-363.
7. Shohet JA, Courey MS, Scott MA, Ossoff RH. Value of videostroboscopic parameters in differentiating true vocal fold cysts from polyps. Laryngoscope. 1996;106(1 Pt 1):19-26.
8. Schwartz SR, Cohen SM, Dailey SH, et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2009;141(3 suppl 2):S1-S31.