Symptoms and Diagnosis of Laryngitis

10 Questions

What is the primary means of diagnosing tracheitis?

Direct visualization by laryngo-tracheo-bronchoscopy

What is the most common cause of acute bronchitis?

Viral infection

What is a characteristic of chronic bronchitis?

Wet cough that lasts for three months or more

What is the primary reason for considering suspicion for tracheitis?

Airway obstruction that does not respond to racemic epinephrine

What is the treatment for mild to moderate cases of tracheitis?

Management at home

What is a common symptom of bronchitis?

Wet cough

What is involved in the pathogenesis of chronic bronchitis?

Smoking, air pollution, and genetics

What is the purpose of laryngo-tracheo-bronchoscopy in tracheitis?

To rule out croup and epiglottitis

What is a common complication of tracheitis that requires admission to pediatric intensive care unit (PICU)?

Intubation and supportive ventilation

What is the duration of wet cough in acute bronchitis?

Around three weeks

Study Notes

Laryngitis

Symptoms include hoarse voice, fever, cough, pain in the front of the neck, and painful swallowing
Symptoms usually last less than two weeks
Vocal cords may be examined via laryngoscopy
Other conditions with similar symptoms include epiglottitis, croup, and foreign body inhalation

Treatment of Laryngitis

Acute form generally resolves without specific treatment
Chronic form occurs most often in middle age and is more common in men than women
Supportive measures include resting the voice, sufficient fluids for hydration and humidification, and antibiotics in bacterial laryngitis

Tracheitis

Symptoms include barking cough following a recent URI, inspiratory stridor, 'scratchy' feeling in the throat, chest pain, labored breathing, fever, ear ache, headache, and dizziness
Caused by Staph. aureus that often follows a recent viral URI
Most serious in young children due to the small size of the trachea that can be easily blocked by edema

Diagnosis of Tracheitis

Diagnosed clinically, often confused with croup
Children can develop symptoms of epiglottitis within hours

Treatment of Tracheitis

Mild to moderate cases are managed at home
More severe cases require admission to pediatric intensive care unit (PICU) for intubation, supportive ventilation, and IV antibiotics
Invasive and non-invasive monitoring may be required in PICU

Epiglottitis

Symptoms include fever, sore throat, stridor, difficult and painful swallowing, drooling, anxiety, and irritability
Diagnosed at emergency care facility, no attempt at home to open the mouth forcefully and view the throat
Oxygen saturation needs to be monitored, and laryngoscopy is performed to look for evidence of epiglottic swelling or obstruction

Treatment of Epiglottitis

Maintaining PaO2 > 94% is an important measure to prevent further complications
Intubation, ventilator support, and tracheostomy may be required
Broad-spectrum antibiotics are used to treat responsible infections, and corticosteroids are used to reduce the edema of the epiglottis

Bronchitis

Symptoms include wet cough, wheezing, shortness of breath, and chest pain
Bronchitis can be acute or chronic
Acute bronchitis is usually caused by a viral infection, while chronic bronchitis is caused by smoking, air pollution, and genetics