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Laryngotracheobronchitis I
OVERVIEW: Subacute viral illness, characterized by barking cough, stridor and fever, often causing upper airway obstruction in children. Most common cause of stridor in children.
System(s) affected: Pulmonary
Genetics: Unknown, though 15% have family history
Incidence/Prevalence in USA: 15,000-40,000/100,000
Predominant age: Childhood
Predominant sex: Male = Female
SIGNS AND SYMPTOMS: • Barking, spasmodic cough
• Biphasic stridor
• Low-grade to moderate fever
• Upper respiratory infection prodrome lasting 1-7 days
• Hypoxia/cyanosis
• Fatigue
• Non-toxic appearing child
• Normal voice, no drooling
• No change in stridor with positioning
• Non-tender larynx
• Inflamed subglottic region
• Normal appearing supraglottic region
CAUSES: • Parainfluenza 1
• Paramyxovirus
• Influenza virus type A
• Other parainfluenza and influenza viruses
• Respiratory syncytial virus
• Other viruses - adenovirus, rhinovirus, enterovirus, coxsackievirus, ECHO virus, reovirus, measles virus
RISK FACTORS: • Past history of croup
• Recurrent upper respiratory infections
DIAGNOSIS DIFFERENTIAL DIAGNOSIS: • Epiglottitis
• Foreign body aspiration
• Subglottic stenosis (congenital or acquired)
• Bacterial tracheitis
• Simple upper respiratory infection
• Subglottic hemangioma
• Diphtheria
LABORATORY: • Leukopenia early
• Leukocytosis in severe later stage
Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A
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