Acute inflammations of larynx

This includes minor catarrhal laryngitis and stenosis - epiglottitis and subglottic laryngitis.

Bluetongue acute laryngitis
It is a common disease affecting all age groups, it usually occurs as part of HCD catarrh. It can occur as laryngotracheitis or laryngotracheobronchitis.


 * Etiology:Most often it is a viral infection (with possible bacterial superinfection), the cause is due to colds, environmental influences, voice abuse.
 * Symptoms:Acute hoarseness, scratching in the throat, cough, cough (initially dry), general symptoms are usually absent.
 * Examination:Laryngoscopy – redness and leakage of the mucosa, especially on the vocal cords.
 * Therapy:Symptomatic - voice calm, humidification, no smoking, fluids, vitamin C, antitussives, ATB with impending superinfection.

Acute epiglottitis
200px|thumb|Viditelná epiglottis u akutní epiglotitidy

https://www.wikiskripta.eu/w/Soubor:Epiglottis.png
 * Suffocating HCD inflammation, peracute laryngitis with extreme swelling of the epiglottis that closes the entrance to the larynx if suffocation is not provided quickly, there is a risk of suffocation.
 * It is rare, mostly affects children, but also adults.


 * Etiology:Haemophilus influenzae type b.
 * Clinical picture:It begins with a sharp cutting sore throat and difficulty swallowing, stagnation of saliva and mucus. Then dyspnoea appears - at first usually while lying on the back.
 * The patient is pale, hypoxic, looking for a relief position - sitting, a slight forward bend, saliva flows out of his mouth, which cannot flow through the valecules along the epiglottis.
 * The child is usually apathetic.
 * Thery tend to be febrile and alterated in the general condition.
 * The epiglottis is usually visible even without a mirror when the tongue is pressed - it is red and swollen.


 * Therapy:transport to the nearest ARO workplace.
 * Transport must be seated with a medical escort ready for emergency airway management.
 * i.v. corticoids, humidify the air.
 * The basic treatment are ATB (aminopenicillins with beta-lactamase inhibitors, cephalosporins).

Acute subglottic laryngitis

 * A special form of laryngitis, swelling of the anatomically narrowest part of the larynx - subglotis.
 * It occurs many times more often than the previous one, the course is less dramatic. Seasonal highs are in spring and autumn.
 * Practically exclusively for children, most often up to five years.


 * Etiology:Viruses (adenoviruses influenza, parainfluenza, myxoviruses), alergy can be a factor too.
 * Clinical picture:It starts suddenly without previous problems.(it can follow the HCD catarrh). At night, there is a sudden seizure of inspiratory dyspnea with inspiratory stridor, jugular twitching and cyanosis may be present. The cough has a barking, croaking character, the voice is rough and harsh, the child is restless, anxious, febrile, the general condition may be altered.
 * Examination:Snažíme se zahlédnout epiglotis, nitro hrtanu nevyšetřujeme (riziko laryngospazmu), jinak bychom pod hlasivkami pozorovali zarudlé, hladké návalky.
 * Therapy:Hospitalization in the case of children. Corticosteroids i.m. (in more severe cases i.v.) - hydrocortisone 10 mg / kg. As a rule, corticoids cause rapid wheezing.
 * In addition to corticoids, we give sedatives, mucolytics (or antitussives and antihistamines).
 * ATB in severe cases of debilitated children at risk of superinfection.
 * Intubation or other securing is required only in exceptional cases.
 * Microclimate adjustment - humidification of inhaled air, calming of the child, adjustment of position, sufficient watering.