Laryngotracheobronchitis or Commonly Called Croup

Laryngotracheobronchitis is also commonly called croup. it'd a viral infection that affects the upper respiratory tract. It can cause airway obstruction in varying degrees. Often, it is a self-limiting condition and will clear up on its own, but occasionally it can become very severe and very rarely can even become fatal. Stridor, fever, and a cough that sounds like a bark are characteristic of the disease and it is also one of the most common causes of stridor. It is often given aggressive treatment and therefore very few cases actually require admission to the hospital. Mainly, it affects children and seeing several days of mild symptoms related to an upper respiratory infection and fever is very common. The infection can extend into the proximal trachea and this will cause a swelling of the subglottic area and diffuse inflammation which can narrow the airway. In the trachea, the cricoid ring is the narrowest portion, especially in a child. Even a small amount of swelling within this region can cause airway obstruction that is considered significant. When air flows through this subglottic and narrowed area it causes stridor (www.emedicine.com,2005).

In three to five days the condition usually goes away but it can persist for as long as ten days. Approximately 5 cases are seen per 100 children during the second year of life. In children between the ages of six months in six years it is the most common form of stridor and airway obstruction. Generally, children with croup do very well. Having any kind of morbidity is unusual and mortality is even much rarer. There is a nearly 2:1 ratio of prevalence in males to females and the most common time for a child to develop this condition is between three months and three years old. The mean age for onset is approximately 18 months. In individuals older than six years, the croup is very uncommon. The barking cough, stridor, and hoarseness that is usually seen is generally between 6 PM and 6 AM and symptoms often get worse on the second night. The child may also be very tired. Upon a physical examination, symptoms may be seen as totally unremarkable all the way to respiratory distress that is severe. There are several things that cause it but parainfluenza type 1 is the most common. Rhinovirus, Reovirus, measles virus, respiratory syncytial virus, and influenza virus type a are some of the other causes of croup (www.emedicine.com,2005).

In making the diagnosis of this condition, the physician usually listens to the chest looking for a prolonged expiration and inspiration, decreased breath sounds, and wheezing. A red epiglottis is sometimes also seen but an examination of the throat is usually undertaken by a physician very cautiously in a very small child. An x-ray can also show a foreign body or other problems. In very mild cases that are caused only by viruses humidified air that is either warm or cold is often used and going outside when the air is cold sometimes is also helpful. There can also be bacterial causes and these need Augmentin or some other type of antibiotic treatment. If a foreign body has caused the problem an ear, nose, and throat specialist will generally remove it. Occasionally, epiglottitis, respiratory arrest, and atelectasis, or collapse of lung tissue, can occur in severe cases. It is very similar to whooping cough, influenza, viral bronchitis, pneumonia, asthma, walking ammonia, and acute mountain sickness, and can sometimes be misdiagnosed as one of these other ailments (www.ecurme.com,2003).