Laryngeal infections
Acute laryngitis
Aetiology:
1. Viral infection of URT, adenovirus or influenza virus, but secondary bacterial infection may supervene.
2. Voice abuse
3. Exposure to fumes, air pollution, smoking and alcohol abuse.
Clinical features:
1. Hoarseness of voice
2. Pain and laryngeal discomfort
3. Cough
5. Flu like symptom
On examination:
May reveal a pharyngitis, the larynx will be red and swollen with thickened vocal cords
.
Treatment:
1. Voice rest
2. Humidification by steam inhalation
3. Avoidance of irritants
4. Analgesia and local soothing agent
5. Antibiotic like Amoxicillin
Recurrent acute laryngitis with incomplete resolution may predispose to chronic laryngitis.
Acute epiglotitis
A special form of acute laryngitis in which the inflammatory changes affect mainly the loosly attached mucosa of the epiglottis.
Pathology:
Localised oedema may obstruct the airway,H.influenzae is usual causative organism
On examination:
Examination is diagnostic but may be delayed until the facilities for intubation and tracheostomy are available so no attempts to depress the tongue or indirect laryngoscopy as this can cause laryngospasm.
Clinical features:
1.Dyspnoea may be progressive and alarming especially in children in which lead to sever stridor and death within few hours.
2. The child may be critically ill, toxic, flushed appearance, and high temperature (38-40)
Treatment
Admission to hospital
Establish the airway by passing endotrachial intubation
I.V line,fluid,sedation,antibiotics
Swab and blood culture
Proper antibiotic(chloramphenicol(100mg\kg\24hours)as up to 30% of haemophilus strains are resistant to penicilline,Third generation of cephalosporins are alternative because of side effect of chloramphenicol
Nasogastric tube should be inserted for feeding
Acute laryngotracheobronchitis(croup)
It is less common dangerous than eiglottitis, it is usually viral infection by parainfluenza virus type one. It occur in children under three years age, Its onset is slow usually 48 hours after previous attach of URTI.It cause barking cough,stridor,but no dysphagia ,the child is feverish,lying on back,struggling,restlessness,horseness of voice, no drooling of saliva with small cervical lymph nodes.
Treatment:
?observation
??reassurance
???humidification
????Oxygen with or without adrenaline, with or without steroid
?????steroid
??????antibiotic for secondary bacterial infection
المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .