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Acute Subglottic Laryngitis

Subglottic Laryngitis (acute)

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.

Hoarseness
  • 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]
  • The main clinical manifestations of the hoarse voice, throat dry feeling.[healthfrom.com]
  • 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]
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]
  • 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]
  • A considerable degree of face cyanosis can occur. Body Temperature is slightly elevated, and the general condition is not heavily disturbed.[laryngitisknowledgebase.com]
  • 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 for[essaymonster.net]
  • Cyanosis is diffuse. Pulse nitividny with fallout on the breath, tachycardia. Child Anxiety gives way to lethargy, drowsiness, confusion arises.[medicalformat.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]
  • It is also acute and self-limiting; thus treatment given is supportive. Respiratory manifestations of the condition include dyspnea, cough, stridor, and hoarseness.[symptoma.com]
  • RESULTS: During a 1 year follow-up period four children showed asthma symptoms and in three of these patients recurrences of croup attacks disappeared after asthma treatment with nebulized budesonide.[ncbi.nlm.nih.gov]
  • Each of the following sections covers anatomy and the diagnosis and treatment of associated diseases and disorders in different areas of the head and neck.[books.google.com]
  • […] laryngitis and subglottic edema (Pseudosulcus) Sequelae of Laryngopharyngeal Reflux - Subglottic stenosis - Carcinoma larynx - Contact ulcer/granuloma - Cricoarytenoid joint fixity - Vocal nodule/polyp - Sudden infant deaths - Laryngomalacia (Association) Treatment[gradestack.com]

Prognosis

  • Treatment and prognosis Croup is usually self-limiting and has a good overall long-term prognosis. Treatment is directed toward improving air exchange. Conservative measures, nebulised adrenaline (epinephrine) and corticosteroids are commonly used.[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]
  • To diagnose false croup has a favorable prognosis and on the background of adequate therapy usually results in complete recovery.[medicalformat.com]
  • 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]

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]
  • 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]
  • Ketokonazole) Systemic antifungal drugs per os (e. ketokonazole) Long treatment 7-14 days after disappearing lesions Inflammation of the Gingiva Gingivitis local etiology Local etiology - dental infection Gingitivits Systemic etiology Systemic etiology[quizlet.com]
  • […] adult patients Invasive meningococcal infections Aseptic meningitis and acute meningoencephalitis Guillain-Barré syndrome Upper respiratory tract infections (excluding influenza) Acute epiglotitis and subglottic laryngitis Community-acquired pneumonia - etiology[wikilectures.eu]

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]
  • […] 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 Herpetic stomatitis epidemiology[quizlet.com]
  • […] 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]
  • An epidemiological study on 5—8-year-old children. Eur J Pediatr. 158; 3: 253—257. ; PMid:10094451 6. Sherman CB, Tosteson TD, Tager IB et al. 1990. Early childhood predictors of asthma. Am J Epidemiol. 132; 1: 83—95. PMid:2356817 7.[med-expert.com.ua]
  • Epidemiology Accurate figures regarding acute laryngitis are not available, as the condition often goes unreported.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Inhalation of dusts / fumes Pathophysiology: Moraxella catarrhalis infections have been attributed. Patients with acute laryngitis show early glottic contact at the mid portion of the mebranous cord. Clinical features: 1. Change / loss of voice 2.[drtbalu.com]
  • 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[en.wikipedia.org]

Prevention

  • 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]
  • […] 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]
  • For statistics data there has been used the EPIINFO aplication, 6.0 version, a program of The Center of Disease Control and Prevention - Atlanta, with the Student method (test t) and χ2.RESULTS Of the total number of 88 children which were paraclinically[essaymonster.net]
  • Prevention Prevention of laryngitis is the same as for any upper respiratory infections.[medical-dictionary.thefreedictionary.com]
  • To prevent attacks give drink fruit juices, sugar water, alkaline mineral water.[ladyjour.com]

References

Article

  1. 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.
  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.

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Last updated: 2018-06-21 20:16