Zapalenia krtani o ciężkim przebiegu u dzieci

*Krzysztof Ślączka¹, Ewa Basiewicz-Ślączka², Lidia Zawadzka-Głos¹, Magdalena Mierzewska-Schmidt²

Summary
Introduction. Acute laryngitis are inhomogeneous group of infectious diseases of larynx, mostly of viral etiology, with peak incidence between 3 and 6 years of age. Usually, it is a self-limited condition, that requires only symptomatic treatment in an outpatient basis. In rare cases the disease leads to acute respiratory failure and needs intensive care management.
Aim. The aim of this study was to analyse severe cases of acute laryngitis in children at the paediatric ICU.
Material and Methods. The retrospective study included 31 patients, aged 3 months-15 years, treated at PICU in 2003-2014 on account of severe infectious laryngitis with acute respiratory failure. The group consisted of 12 children presented with epiglottitis, 13 with subglottic laryngitis and 6 with bacterial tracheitis.
Results. Acute laryngitis treated in PICU was mostly of bacterial etiology, 18 patient with epiglottitis, bacterial tracheitis (58%). Signs and symptoms, laboratory tests and culture results confirmed diagnosis. In 13 cases of subglottic laryngitis viral etiology was diagnosed, which means low level of inflammatory markers and negative cultures. In all cases acute respiratory failure was main reason for admission to PICU. 29 patients needed endotracheal intubation and mechanical ventilation, 2 patient was left breathing spontaneously. The mean intubation duration was 5.16 days. All patient had antibiotic treatment administered. The mean ICU length of stay was 7.35 days.
Conclusions. Acute laryngitis can have a severe course, although adequately diagnosed and early treated. Epiglottitis hasn’t been reported since the obligatory introduction of anti-HIB vaccine in Poland in 2007.

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