28. Acute and chronic infections of the larynx, acute epiglottitis, phlegmonous epiglottitis, abscess of the epiglottis
- Acute laryngitis
- Benign disorder
- Also called "false croup"
- < 3 weeks duration
- Etiology
- Infectious
- Descended URTI
- Viral
- Rhinovirus
- Adenovirus
- Bacterial superinfection
- Non-infectious
- Vocal strain
- Airborne irritants
- Infectious
- Clinical features
- Hoarseness
- Dry cough
- Related disorders
- Croup – laryngotracheitis
- Epiglottitis
- Diagnosis
- Laryngoscopy – erythema, oedema of larynx
- Treatment
- Self-limiting
- Vocal rest
- Steam inhalation
- Antibiotics if bacterial
- Chronic laryngitis
- > 3 weeks duration
- Etiology
- Ascending or descending inflammation
- GERD
- Smoking
- Recurring URTI (postnasal drip)
- Epiglottitis
- Severe phlegmonous infection, quickly progressing
- Important to consider it in all children with stridor
- Less common after H. influenzae vaccine
- Mostly in young children
- Etiology
- H. influenzae
- S. pneumoniae
- Clinical features
- High fever
- Inspiratory stridor
- Odynophagia
- Drooling
- Leaning forward
- No cough
- Management
- Urgent to hospital
- Airway may collapse rapidly, must be prepared to intubate, no inspection of the pharynx before you're prepared
- Visualisation of inflamed epiglottis by laryngoscopy
- IV antibiotics
- Complications
- Abscess (rare)