Acute laryngotracheobronchitis in children

Introduction to acute laryngotracheal bronchitis in children Acute laryngotracheal bronchitis (acutelaryngotracheobronchitis) refers to acute diffuse inflammation of the larynx, trachea, and bronchus caused by infection with viruses or bacteria. It is characterized by edema under the throat and vocal cords, thick and sputum of tracheobronchial exudate and symptoms of poisoning. It mainly occurs in infants and young children, with the highest incidence of children aged 2 years and older, and the incidence of males is higher than that of females. The disease often occurs during the cold season. basic knowledge The proportion of illness: 11% Susceptible people: children Mode of infection: non-infectious Complications: pneumonia

Causes of acute laryngotracheal bronchitis in children

Virus infection (45%):

Common pathogens are viruses (mainly parainfluenza viruses, adenoviruses, syncytial viruses), but they are easily secondary to bacterial infections, with Haemophilus influenzae as the main pathogen, others with hemolytic streptococcus, pneumococci and gold. Staphylococcus aureus, etc.

Disease factors (35%):

When children suffer from acute infectious diseases such as measles, flu, and scarlet fever, they are also prone to this disease. Because infants and young children have narrow airways, they may experience severe breathing difficulties when they have airway inflammation.

Low immunity (20%):

Due to the weak resistance of children aged 2 to 5 years old, the cough function is poor, and the dry and cold air in winter is not conducive to the movement of mucus ciliary system and alveolar gas exchange in the respiratory tract, resulting in thick secretions that are easy to become phlegm, block the airway, and the mucous membranes of the affected area are eroded. An ulcer is formed and falls off, which makes the airway obstruction further aggravated, causing severe breathing difficulties.

Prevention of acute laryngotracheal bronchitis in children

Prevention of acute respiratory infections is the key to reducing this disease. Once the disease is involved, it should be actively treated early.

Complications of acute laryngotracheal bronchitis in children Complications pneumonia

The most common infection is spread to other parts of the respiratory tract, such as the middle ear, terminal bronchioles, or lung parenchyma. In addition, mediastinal emphysema and pneumothorax are common complications of tracheotomy.

Severe cases of edema in the respiratory mucosa, ulcers and fibrous exudation, the formation of pseudomembrane, and lower airway obstruction and pneumonia.

Acute laryngotracheal bronchitis symptoms in children Common symptoms Canine-like cough, wheezing, hoarseness, dyspnea, dysphoria, irritability, high fever, stagnation, sputum, dry cough

History

Most children are children aged 2 to 5 years old. They often have viral upper respiratory tract infections, measles, flu, scarlet fever and other pre-infections. The prodromal period is 1 to 2 days.

2. Clinical manifestations

(1) Symptoms: rapid onset, initial irritating cough and inspiratory throat, followed by canine-like cough, hoarseness, difficulty breathing, symptoms characterized by exacerbation at night, when infected along the bronchi and bronchioles When it spreads downward, it can make breathing difficulties worse, exhale also becomes laborious, and the time is prolonged. At this time, both inhalation and exhalation are difficult, and the condition is more serious. Most children have moderate to high fever and systemic poisoning symptoms. It is difficult to breathe and breathe when you are quiet or sleep. It is difficult to exhale and inhale when you are active or crying. The condition can develop further. You can have high fever, severe bruising, irritability and struggle, breathing, heart rate, and your face is turned from hair to hair. It is pale, vain, and coma. If the rescue is not timely, it will die due to lack of oxygen and systemic failure.

(2) Signs: obvious signs of three concaves, audible airway abnormal signs such as wheezing wheezing or tracheal slap sound, partial or total reduction of breath sounds in both lungs, dry and wet squeaks, chest X-ray examination visible bronchus Inflammation, atelectasis or emphysema, starting with symptoms of upper respiratory tract infection, dry cough and inspiratory throating after a few days, followed by canine disgusting cough, hoarseness, phlegm sticky and not easy to cough up, inhalation difficulty breathing And hairpins.

Examination of acute laryngotracheal bronchitis in children

Increased white blood cells, up to (20 ~ 30) × 10 ⁹ or above, may have toxic particles and nuclear left shift, blood gas analysis has obvious hypoxemia.

1. X-ray examination: visible bronchitis, emphysema, atelectasis and other signs.

2. Direct laryngoscopy or tracheobronoscopy: visible laryngeal, tracheal, bronchial mucosa highly red, swollen glottis and subglottic stenosis, thick secretions in the trachea and bronchi, or purulent obstruction.

Diagnosis and diagnosis of acute laryngotracheal bronchitis in children

diagnosis

According to the medical history and clinical manifestations, the diagnosis can be confirmed, and laryngoscopy or bronchoscopy can be performed if necessary.

Differential diagnosis

Acute epiglottis

The disease mainly invades epiglottis, phlegm and wrinkles, and the lesion progresses rapidly. It can cause severe laryngeal obstruction within minutes to hours, mostly due to infection with Haemophilus influenzae. When examined, it is seen under the pharynx of children. The swollen cherry-like epiglottis, laryngoscope and lateral laryngeal film can be consulted.

2. Throat diphtheria

Diphtheria is an acute infectious disease caused by diphtheria bacilli. Generally, a film-like white exudate or pseudomembrane is visible in the tonsils and tissues around the pharynx, and it is not easy to be wiped off. It is easy to cause bleeding after scraping off the leucorrhea, and the symptoms of laryngeal diphtheria generally develop. Slower, dyspnea and systemic poisoning symptoms are more obvious after 2 to 3 days of hoarseness.

3. Respiratory foreign bodies

There is a history of inhalation of foreign bodies. After inhalation of foreign bodies, there are symptoms such as coughing and difficulty in breathing. X-ray examination may have one side of atelectasis or emphysema and mediastinal shift. If necessary, a laryngoscopy or bronchoscopy is needed to assist in diagnosis.

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