Epiglottitis (or supraglottitis) is seen among children aged 2 to 8 years; it uncommonly produces the barking cough heard with laryngotracheobronchitis
. The infection leads to cellulitis of the epiglottis, aryepiglottic folds, and surrounding soft tissues (Figure 8), and progresses rapidly within a matter of hours.
He was transferred to the pediatric intensive care unit in stable condition for observation, with a guarded prognosis and a diagnosis of upper airway obstruction from chemical epiglottitis and laryngotracheobronchitis
; drug therapy was discontinued, and no additional treatments were administered.
35 (18.6) Symptom days before care sought, median 5 (0-21) (range) Diagnostic method PCR 51 (27.1) Immunofluorescence 137 (72.9) Type 4 40 (21.3) 7 86 (45.7) Others (1, 2, 3, 5, 11) 33 (17.6) Unknown 29 (15.4) Syndrome Upper respiratory tract infection 107 (56.9) Acute laryngotracheobronchitis
1 (0.5) Bronchiolitis/bronchitis 13 (6.9) Tonsillitis 11 (5.9) Otitis media 2 (1.1) Conjunctivitis 0 Pneumonia 35 (18.6) Gastroenteritis 15 (8.0) Disseminated adenovirus 1 (0.5) Hemorrhagic cystitis 3 (1.6) Mechanical ventilation 13 (6.9) Hospitalization days, median (range) 4 (1 -247) Died 6 (3.2) * Values are no.
An interesting finding of this study was the lower occurrence of croup (laryngotracheobronchitis
), the signal illness for HPIV.
The LRTI category included acute bronchitis and bronchiolites, acute lower respiratory infection NOS, chest infection NOS, laryngotracheobronchitis
, tracheobronchitis, bacterial and viral pneumonia, bronchopneumonia, influenzal pneumonia, and pneumonitis.
Two such pulmonary conditions frequently seen among this group of patients are epiglottitis and laryngotracheobronchitis
. In this article, the etiology, pathophysiology, signs and symptoms, diagnosis, and treatment of these two upper airway disorders will be presented.
The medical term for croup is laryngotracheobronchitis
The differential diagnosis for a child suspected of having epiglottitis also includes retropharyngeal abscess or cellulitis, laryngotracheobronchitis
(croup), foreign body aspiration, angioneurotic edema, and expanding congenital anomaly (eg, cyst or hemangioma). If epiglottitis is suspected, the diagnosis should be confirmed as soon as possible and therapy begun immediately.
Case-patients were children admitted for an acute RTI (mostly bronchiolitis, pneumonitis, and laryngotracheobronchitis
) who had a nasopharyngeal aspirate (NPA) collected as part of investigation of their illness.
Laryngitis ("croup," epiglottitis, and laryngotracheobronchitis
) has many causes, including viral, bacterial, mycotic, or mycobacterial infections, trauma, neoplasms, vascular compromise during surgery, iatrogenic injury from feeding tubes or tracheostomy tubes, foreign-body impaction, and radiation therapy.