Acute subglottic laryngitis (ASL) is an inflammatory condition of the larynx, which causes narrowing of the latter. It predominantly occurs in children and presents with difficulty in breathing, voice changes, and a barking cough.
Presentation
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.
Entire Body System
- 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]
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]
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]
- Soft Tissue Swelling
Soft-tissue films of the neck may demonstrate marked edema of the submental and submandibular soft tissues. Air in the soft tissues may be noted if the infection is due to gas-forming bacteria. [ahcmedia.com]
- Fishing
Retropharyngeal and epidural abscess from a swallowed fish bone. Am J Emerg Med 1997;15:381-383. 36. Nadal DM, Lyons KM. "Shotgunning" crack cocaine as a potential cause of retropharyngeal abscess. Ear Nose Throat J 1998;77:47-49. 37. [ahcmedia.com]
Respiratoric
- 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]
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]
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]
- Respiratory Distress
The degree of respiratory distress at presentation is variable. The initial lack of respiratory distress can deceive the unwary clinician; respiratory distress can also be the 1st manifestation. [clinicalgate.com]
Respiratory distress is rare with the exception of young infants. If diphtheria is the cause, respiratory distress with airway compromise is quite marked secondary to the pseudomembrane blocking the laryngeal inlet. [virtualpediatrichospital.org]
In unilateral vocal cord paralysis, the infant's cry is weak and feeble; however, there is usually no respiratory distress. [aafp.org]
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]
The respiratory tract in children is relatively narrow in this region and the chondrous ring limits the size of the subglottic region. So, oedema in this region may have a dramatic course, leading even to acute respiratory distress [3]. [czytelniamedyczna.pl]
Gastrointestinal
- 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]
Cardiovascular
- 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]
Neurologic
- Excitement
The exciting cause is practically the same as in the previous class. [operatingmicroscopes.com]
- Insomnia
I was experiencing terrible viral throat infection white spots tonsils sore throat jaw sore fever migraine headaches fatigue insomnia and nausea. [elmemesser.eu]
- 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]
Workup
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].
Treatment
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]
Subglottic laryngitis treatment If subglottic laryngitis leads to the need that the child should be admitted to a otorhinolaryngological department, due to heavy breathing, a similar treatment as for acute laryngotracheobronchitis is to be applied. [laryngitisknowledgebase.com]
Prognosis
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]
Etiology
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]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
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]
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]
Epidemiology
[…] 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]
Pathophysiology
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]
Prevention
[…] 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]
References
- Pucher B, Jonczyk-Potoczna K, Buraczynska-Andrzejewska B, et al. Environmental pollution and parental smoking influence on the appearance of pseudocroup in children. Ann Agric Environ Med. 2013;20(3):580-582.
- Cherry JD. Croup. N Engl J Med. 2008;358(4):384–391.
- Rosekrans JA. Viral croup: current diagnosis and treatment. Mayo Clin Proc. 1998;73(11):1102–1107.
- Wood JM, Athanasiadis T, Allen J. Laryngitis. BMJ. 2014;349:g5827.
- Vaughan CW. Current concepts in otolaryngology: diagnosis and treatment of organic voice disorders. N Engl J Med. 1982;307(14):863-866.
- Ng ML, Gilbert HR, Lerman JW. Some aerodynamic and acoustic characteristics of acute laryngitis. J Voice. 1997;11(3):356-363.
- 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.
- Schwartz SR, Cohen SM, Dailey SH, et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2009;141(3 suppl 2):S1-S31.