Acute supraglottic laryngitis

Acute hyperinflammation is a disease that occurs more frequently in children than in adults. It is a rare form of acute laryngitis that is characterized by airway obstruction and respiratory failure. The disorder begins with pain in the upper part of the larynx, which, when swallowed, causes such pain that the patient resigns from eating and drinking altogether.

What is acute supragastric laryngitis?

Acute hyperinflammation of the larynx is a rare form of laryngitis that occurs more often in children than in adults (usually from 2 to 6 years of age). If it appears in adults - it has a much milder course. The supraglottic laryngitis is characterized by airway obstruction and respiratory failure. Before the introduction of vaccination, the main pathogens responsible for this disease were Moraxella catarrhalis and Staphylococcus aureus (Staphylococcus aureus). The disease begins suddenly with pain in the area of ​​the upper part of the larynx, which when swallowed intensifies to such an extent that the patient avoids swallowing. The result is abundant salivation. From the beginning of the disease there is high temperature and rapidly increasing dyspnea . At the first symptoms, the patient should be transported to the ward of the laryngological department immediately.

Frequency of acute suprarenal laryngitis

In the years 1989-1992, the p / Hib vaccine was introduced, which significantly reduced the number of cases. Currently, the disease appears very rarely and usually attacks people who are unvaccinated and adults. Similarly, mortality rates among children decreased. Inflammation of the supraglottium may occur in rare cases in vaccinated children. In 2013, the World Health Organization issued a recommendation to the public information on obligatory vaccinations in all member countries. In contrast, from 2010, mandatory vaccination of children has started in 119 countries. In Poland, the obligation to vaccinate children against staphylococcus bacteria was introduced in 2007.

The course of acute supraglottic laryngitis

After appearing within 6-12 hours of fever and symptoms indicating inflammation of the upper respiratory tract, laryngeal dyspnea occurs, which is accompanied by significant deterioration of the patient's condition. The intensity of symptoms is caused by the growing inflammatory swelling in the soft tissue of the epiglottis and the epidural-epiglottic folds. The result of this is the movement of the swollen epiglottis in the posterior-lower direction, which in turn leads to a reduction in airflow. The child's breath begins to be shortened and accelerated, so it should be placed in a position that facilitates breathing, that is, leaning forward with the head tilted back.

In addition, there is an unbearable sore throat in acute supragastric laryngitis that increases when swallowing food or liquids. In this type of laryngitis, coughing and hoarseness do not occur (in contrast to subglottic laryngitis). After all, the child's voice may be slightly changed and indistinct. The disease in children up to 1 year of age can manifest only in high temperature and developing respiratory failure. In contrast, in older children and adults, only a severe sore throat (despite swollen loudness)

Diagnosis and treatment of acute supraglottic laryngitis

During a standard examination of the oral cavity, the doctor is able to see the epiglottis in the child, so he can directly assess the extent of edema.

In children with suspected acute supraglottic laryngitis, a laryngologist and anesthesiologist should be consulted. In life-threatening conditions, intubation is performed to open the expensive respiratory tract, and because the soft tissues of the throat are swollen - it is difficult. Therefore, in any case, doctors must be prepared that tracheotomy may be necessary.

Then, the specialists perform an intravenous injection and take a blood sample and a bacterial swab for testing. If expensive breaths have been well-cleared, direct laryngoscopy is performed along with determining what character and extent the laryngeal infiltration has. In addition, a throat swab is collected.

Another study is a direktoscopic examination of the larynx, which reveals redness and swelling of the epiglottis and the epidural-epiglottic folds. Further therapy should take place in a hospital under the care of a pediatrician. The stay in the intensive care unit usually lasts about 5 days, and extubation is carried out after two days (provided that an air leak has appeared around the tracheal tube). Before the doctor removes the tube, he should re-evaluate the patient's inflammation - if the edema has been reduced, the child can be uninterrupted.