Progression of acute laryngitis

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Based on the cause of the disease and clinical manifestations as well as age, acute laryngitis is classified into many types. In adults, the disease can rarely cause serious conditions. However, children need to be closely monitored because it is easy to cause difficulty breathing in the larynx, affecting the life of children, because the disease can progress to bronchitis and pneumonia.

1. What is acute laryngitis?

Acute laryngitis is an inflammation of the lining of the larynx that lasts less than 3 weeks. Causes of acute laryngitis are many, depending on the cause and age, acute laryngitis is classified as follows:
Acute laryngitis in adults: This type of laryngitis includes: exudative laryngitis, edematous laryngitis, influenza laryngitis... Acute laryngitis in children: acute subglottic laryngitis, acute spasmodic laryngitis, acute diphtheria laryngitis , epiglottitis. The common causative agent of acute laryngitis is a virus (eg Influenzae influenza, APC...); bacteria (eg Pneumococcal S.pneumoniae, Hemophilus influenzae...) and by diphtheria bacilli.
In addition, people with nasal sinus disease, lung disease, pharyngitis, diabetes in the elderly or people who use a strained voice, choke on irritants or people with reflux of the throat and vocal cords laryngitis, allergies will have a higher risk of acute laryngitis.

2. Progression of acute laryngitis

Acute laryngitis in children and adults usually progresses in the same order as the causative agent. The progression of the disease is as follows:
Acute laryngitis in children Acute subglottic laryngitis: This is a common disease in children aged 1-3 years old and with nocturnal onset in children with common pharyngitis. often. Acute subglottic laryngitis will progress slowly and suddenly appear symptoms of laryngeal dyspnea, cough and snoring, the voice then becomes deeper, the child still plays normally in the morning but at night Shortness of breath reappears if left untreated.
Diphtheria pseudo-laryngitis or spasmodic laryngitis: In this type, inflammation and edema will be localized in the lower pharynx, laryngospasms cause symptoms of shortness of breath for children at midnight. shining. In addition, the child will have shortness of breath and stridor, voice becomes hoarse, cough and have contractions of respiratory muscles as well as intercostal muscles. Shortness of breath in a child may pass in half an hour, followed by another episode of dyspnea. The child did not have hyperthermia and no other systemic signs.
Inflammation of the epiglottis: When the epiglottis is swollen, the child often has pain when swallowing, difficulty breathing and increased salivation, the child's neck is tilted forward and the symptoms of shortness of breath increase when the child is lying on his back.
Acute diphtheria laryngitis: Caused by Loeffler bacteria entering the larynx leading to edema and ulceration with pseudomembranous membranes. These pseudomembranous membranes are white, sticky and tough, so they will block the airways, thereby worsening laryngeal dyspnea, children speak more hoarsely with endotoxin shock. This form of acute laryngitis is very severe, so it can easily lead to death in children when not treated properly and promptly.

Acute laryngitis in adults Acute laryngitis due to influenza: This form is usually caused by influenza alone or can be combined with another bacteria causing typical symptoms of pharyngitis such as sore throat, difficulty breathing, fever. , stuffy nose, muscle pain...
Acute exudative laryngitis: In this form of the disease, the patient has fever, prolonged fatigue, there may be bleeding points under the mucosa.
Acute edematous laryngitis: Acute edematous laryngitis is a subsequent condition of exudative. Symptoms of edema may be localized to the posterior aspect of the cartilage of the funnel and the epiglottis. In addition, the person will have pain in swallowing and sometimes difficulty breathing.
Acute ulcerative laryngitis: There are superficial ulcers in the larynx, red margins, edema of the funnel cartilage and the epiglottis.
Inflammatory form: Severe systemic symptoms, high fever, rapid pulse, emaciated face. Patients have functional symptoms such as difficulty swallowing, sore throat, throbbing in the ears, hoarse or completely lost voice, difficulty breathing in the larynx. In addition, the area in front of the larynx will be inflamed and painful due to swelling. After the inflammation is gone, the disease will leave a scar scar on the larynx.
Necrotic form: The loose connective tissue in the neck will be inflamed, hard, possibly with pus, the larynx is enlarged and covered with a pseudo-membrane when the cartilage is inflamed and necrotic. After that, the disease progresses further, making it difficult for the patient to speak, breathe, and painful to swallow. Body temperature is also elevated, pulse is fast and weak, breathing is rapid but shallow, urine contains albumin, blood pressure drops, more dangerous is bronchial death, cardiovascular collapse.

3. Treatment of acute laryngitis

In principle of treatment, for cases of acute laryngitis without difficulty breathing, it is still best to abstain from talking, avoid cold, and at the same time use antibiotics, reduce inflammation, antihistamine H1, reduce cough, and expectorant sputum. , anti-inflammatory corticosteroids, anti-inflammatory enzymes, essential oils... and improve resistance by supplementing with adequate nutrition and electrolytes.
In case of acute laryngitis with difficulty breathing, depending on the degree of difficulty breathing to take appropriate measures. For grade I dyspnea, only medical treatment is required, grade II dyspnea requires emergency tracheostomy and grade III requires emergency tracheostomy combined with active resuscitation. Specific treatment is as follows:
Use of antibiotics:
Use of beta-lactam antibiotics such as: Cephalexin, Amoxicillin, 1st and 2nd generation cephalosporins (cefadroxil, cefaclor, cefuroxime) and beta lactamase inhibitors (eg. eg clavulanic acid, sulbactam...) Macrolide antibiotics such as: Roxithromycin, clarithromycin or Azithromycin,... Anti-inflammatory drug use:
Anti-inflammatory steroids: Anti-inflammatory drugs used to treat acute laryngitis is prednisolone, methylprednisolone or dexamethasone... Using anti-inflammatory enzymes such as alphachymotrypsin, lysozyme... Local treatment:
Using nebulizer, laryngeal pump with anti-inflammatory corticosteroids and anti-inflammatory enzymes, antibiotics. In addition, for older children and adults, it is necessary to gargle with antiseptic solutions, reduce local inflammation, reduce fever, relieve pain by infusion, use paracetamol or aspirin... as directed by the doctor. Strengthening resistance:
Full complement of trace elements, vitamins, vitamins, nutrition... to enhance resistance, fight against pathogens. Acute laryngitis in adults can rarely cause serious conditions. However, children need to be closely monitored because it is easy to cause difficulty breathing in the larynx, affecting the life of children, because acute laryngitis can progress to bronchitis, pneumonia.
Therefore, to prevent these dangerous complications, the best way to prevent disease is to keep children warm in the cold season, adults should not abuse their voices excessively. At the same time, you should not have direct contact with people who are suffering from respiratory diseases such as pharyngitis, rhinitis, .... If children have acute laryngitis, parents need to closely monitor to detect bad progress, then take the child to the emergency room promptly.

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