Barking cough

Introduction Canine-like cough, coughing sounds such as canine distemper, more common in epiglottis, throat disease or tracheal compression, common in children with acute laryngitis.

Cause

More secondary to rhinitis, pharyngitis, upper respiratory tract infections. It can be a precursor to acute infectious diseases such as influenza, pneumonia, measles, chickenpox, whooping cough, and scarlet fever.

an examination

Related inspection

X-ray lipiodol angiography blood routine otolaryngology CT examination chest CT examination

diagnosis

History: more common in children, acute onset.

Symptoms: There may be different degrees of fever, hoarseness, canine-like cough and inspiratory throat. The symptoms are mild during the day. After falling asleep, the throat muscles are slack and the secretions are blocked, causing nighttime symptoms to worsen.

Signs:

1. Children are more common and have an acute onset.

2. There may be different degrees of fever, hoarseness, canine-like cough and inspiratory throat.

3. The throat is congested, the false vocal cords are swollen, and the mucosa under the glottis is swollen.

4. The symptoms are lighter during the day. After falling asleep, the throat muscles are slack and the secretions are blocked, causing the nighttime symptoms to worsen.

5. The laryngeal obstruction is divided into the following 4 degrees:

I degree: If you are a normal person when you are quiet, you will only have inspiratory throat and difficulty breathing after the activity. The lungs have clear breath and no change in heart rate.

II degree: There is also a laryngeal and inspiratory dyspnea when it is quiet. The auscultation of the lung can hear the throat conduction sound or the tubular breath sound, and the heart rate is faster.

III degree: In addition to the symptoms of II degree laryngeal obstruction, the patient developed irritability due to lack of oxygen, cyanosis, fear and sweating. The aspiration rate of the lungs was significantly reduced, the heart sounds were low and the heart rate was accelerated.

IV degree: After struggling with difficulty breathing, it gradually becomes exhausted and drowsy. Due to the inability to breathe, the performance was temporarily quiet, and the three concave signs were not obvious, but the face was pale and gray. The auscultation of the lungs disappeared altogether, only the tracheal conduction sound, heart sounds blunt, heart rate or fast or slow, irregular.

Physical examination: the throat is congested, the false vocal cords are swollen, and the mucosa under the glottis is fusiform. According to the degree of the lesion, throat laryngeal and inspiratory dyspnea may occur, and the auscultation of the lung may hear the throat conduction sound or the tubular breath sound.

Differential diagnosis

Persistent cough is a precursor to lung disease. This cough will take two to three months to heal once it starts, and any cough medicine seems to be powerless.

Sputum cough is characterized by severe cough, coughing and snoring, a cough can be dozens of sounds to dozens of sounds for a long time, coughing redness on the face and neck, breathing is affected, coughing is often required after a pause Inhalation, severe cough often causes glottic sputum, a chicken-like sound, persistent coughing often causes retching, coughing for a while and then quiet for a while, and then start coughing, can cause children with tongue ulcers, conjunctiva Bleeding, severe gastrointestinal fistula caused by increased abdominal pressure due to cough, inguinal hernia and rectal prolapse, spastic cough is common in pertussis, parapertussis and some adenovirus infections. If there is obvious cough, the peripheral blood counts of white blood cells and lymphocytes are significantly increased, according to these characteristics can make a clinical diagnosis of whooping cough. In addition, bacterial culture positive or serological immunology, positive PCR test can confirm pertussis.

Cough is accompanied by sputum called wet cough. Can be seen in pneumonia, bronchitis, bronchiectasis, lung abscess, fibrovascular tuberculosis and so on. Early mild dry cough, then turned into a wet cough, snoring or coughing up yellow purulent, early symptoms of cold, such as fever, sneezing, salivation, pharyngeal discomfort.

When you cough, there is no such thing as a dry cough. Can be seen in acute pharyngitis, bronchitis, early tuberculosis, pleurisy and so on.

Paroxysmal intermittent discontinuities occur, there is no persistent state, paroxysmal cough is a description of the form of seizures, there is no cause, so there is no meaning, most of the episode cough is allergic cough.

Allergic cough is caused by prolonged unhealed virus infection and bacterial infection, and allergic factors are involved. Diagnostic criteria:

1, chronic cough.

2. The lung function is normal and the airway hyperresponsiveness test is negative.

3, has one of the following characteristics

(1) History of exposure to allergens

(2) Allergen skin test positive

(3) Increase in serum total IgE or characteristic IgE.

(4) Increased cough sensitivity. 4 Exclude chronic cough caused by CAV, upper airway cough syndrome, EB and other causes. 5 glucocorticoids or anti-allergic amines are effective.

Chronic cough refers to a history of chronic respiratory diseases without a corresponding chest, physical examination of the chest and chest radiographs, no abnormal findings, that is, the exclusion of organic diseases such as lung cancer, the use of conventional anti-infection or antitussive treatment is invalid. Such patients are most easily neglected by doctors and patients themselves, and the causes of chronic cough are numerous and extensive. Many patients have been misdiagnosed as "chronic bronchitis" or "bronchitis" for a long time. The use of antibacterial drugs is ineffective. It is often difficult to diagnose and repeat various tests, which not only increases the patient's pain, but also increases the patient's financial burden. Affect the patient's daily work and quality of life, increasing the incidence of adverse drug reactions. In addition, frequent coughing can cause a variety of complications. Cough may be the only symptom of asthma, mainly long-term intractable dry cough, often induced by inhalation of irritating odor, cold air, exposure to allergens, exercise or upper respiratory tract infection, and some patients have no incentives. More intensified at night or in the early hours of the morning. Some patients have a certain seasonality, with more spring and autumn. Most patients have been treated with cough and expectorant drugs and antibiotics for a period of time, almost no effect, and the use of glucocorticoids, anti-allergic drugs, 2 receptor agonists and theophylline can be alleviated.

Clinical manifestation

Pediatric acute laryngitis is common in infants from 6 months to 3 years old. Due to the anatomical features of the throat of the child, the throat is narrow, the laryngeal cartilage is soft, the epiglottic cartilage tongue, the sacral cartilage, the sickle-like epiglottis, the submucosal tissue in the subventricular zone and the subglottic area are loose, the mucosal lymphatic vessels are rich, and it is easy to swell after inflammation. A throat blockage has occurred. The cough function of children is not strong, and it is not easy to discharge the secretions of the throat and lower respiratory tract, which makes the breathing difficulty worse. Therefore, the condition of acute laryngitis in children is often more serious than that of adults. If not treated promptly, it can be life-threatening.

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