Laryngotracheitis - is infectious inflammation of the larynx and trachea, accompanied by signs of acute respiratory infection.
In adults laryngotracheitis manifested impaired breathing and painful cough, and the children may show signs of severe complications - false croup.
Causes
Laryngotracheitis usually develops in children, although they may be ill adults. Often laryngotracheitis is a complication of acute respiratory infection or occurs with a decrease in the immune defense or in the respiratory system, or whole organism. The disease can occur each individually - laryngitis or tracheitis, but usually due to structural features of the bodies flow together, and deliver similar clinical manifestations.
The main causes of laryngotracheitis is:
- respiratory viral lesions (especially dangerous virus flu, parainfluenza and adenovirus),
- bacterial lesions (streptococcal or staphylococcal, tubercular)
- mycoplasma defeat,
- herpes lesions,
- allergic reasons
- chemical agents.
Aggravating factors for the development of laryngotracheitis are:
- inhaling dusty and polluted air.
- heart-rending cry,
- loud singing,
- smoking, alcohol,
- general symptoms of hypothermia or freezing feet.
development mechanism
Trachea performs the function of air-conducting tubes and inflammation may occur in the region of its mucosal edema. This leads to the formation of difficult to discharge the content, infringing irritant receptors and carrying air masses.
Larynx, besides air-conducting function, plays a role also golosoobrazovatelnogo element. Due to the vocal cords. Flows of air and vibrations create certain ligaments sound audible ear.
When inflammation of the vocal cords are damaged and become swollen, and the region peridesmic fiber starts accumulating fluid and compress the region of the larynx.
complication may occur - false croup (swelling with compression of the airway and suffocation).
Classification
Distinguish acute and chronic laryngotracheitis. Acute laryngotracheitis divided into
- primary, which is detected for the first time,
- relapsing occurring repeatedly at neblagopriyanyh factors occurs colds or action.
Primary acute laryngotracheitis embodiment may have three currents:
- sudden laryngotracheitis without signs of acute respiratory infections,
- acutely occurring against the background of the existing ARI,
- gradually arises as a complication of colds.
Downstream acute laryngotracheitis can be continuous, or undulating.
Chronic laryngotracheitis occurs when the wrong treatment of acute or in the absence of his treatment. Often it occurs when a professional overvoltage ligaments.
Vydelyut three forms of the disease:
- catarrhal, at which there is some swelling and redness in the area of the vocal cords and trachea
- atrophic, there is a gradual atrophy in the mucosa area, due to which it loses its protective properties and inflamed. Often in smokers and workers of coal mines, the people working in dusty environments
- hyperplastic, manifested sprawl areas or the entire area of the mucous in the trachea and larynx, as a result suffers from breathing and voice
Manifestations of acute laryngotracheitis
Acute laryngotracheitis manifests itself in the background SARS, Beginning acutely or gradually. there are:
- sharp temperature jump,
- sore throat,
- soreness behind the sternum,
- rough, dry cough with soreness,
- cough has character croaks or barking due to the abrupt swelling and spasm of the vocal cords,
- during coughing chest pain intensified,
- cough attacks occur in laughter, deep breathing, inhaled cold air or dusty,
- is allocated a small number of thick and viscous mucus,
- hoarseness or hoarseness in the voice,
- discomfort in the throat with a dry, zheeniem.
As the process of cough becomes wet, less painful, with a lot of phlegm muco-purulent character.
Can react cervical lymph nodes - they become painful and enlarged. When listening to the lungs marked hard breathing and dry rales in the projection of the trachea.
Symptoms of chronic process
Chronic laryngotracheitis occurs gradually, the main symptoms:
- voice disorders, from mild hoarseness and dysphonia, until the complete lack of voice - Athos,
- coughing, provoke laughter, cold or deep breathing,
- pain in the throat and chest,
- voice fatigue (prolonged singing or speaking) may occur.
Exacerbation of chronic laryngotracheitis may occur when hormonal changes in women, with colds, after stress, after heavy loads on the cords - with screaming, singing with anguish.
In chronic laryngotracheitis cough is usually a constant, with little sputum, and against the background of frequent exacerbations of cough and sputum becomes larger. Against the background of cough, in the larynx and trachea may be a feeling of itchiness and dryness.
Diagnostics
The basis of diagnosis is a common complaint of the patient - a hoarse voice, dry cough and chest pain, as well as inspection and listening to the lungs and trachea region.
Conducted laboratory studies:
- general blood analysis,
- general urine analysis,
- bacteriological examination of sputum,
- if technically possible - serologic tests for respiratory virus infections.
Complemented by the diagnosis and conduct mikrolaringoskopii tracheoscopy - examination of the vocal cords and larynx with the help of a special device, if necessary, are assigned an X-ray and CT larynx and trachea.
In chronic laryngotracheitis necessary laryngoscopy with a fence piece of tissue for a biopsy to exclude cancer, and in the event of wheezing - chest X-ray with the exception of pneumonia and bronchitis.
It is important to distinguish from the foreign body laryngotracheitis larynx and trachea, from diphtheria and laryngeal papillomatosis, retropharyngeal abscesses.
* Check with federal recommendations for the diagnosis and treatment of laryngotracheitis in children, according to which this article is written.
laryngotracheitis treatment
Treatment laringotraheita engaged therapists, general practitioners and ENT doctors in uncomplicated treatment on an outpatient basis, under the supervision of a physician clinics.
In acute or chronic process needs to cough relief receiving large amounts of warm fluids as tea, compotes, can brew chamomile, breast charges. Indoor air humidification and requires coolness.
It does not need to shoot down it with a moderate increase in body temperature and satisfactory tolerability, as it helps the body fight the virus, if the temperature is above 38,5ºS can take paracetamol or combined means (for example, tera-Flu or koldreks).
At the beginning of the disease is possible to use antiviral agents (anaferon, ergoferon) scheme for 5 days. If on the 4th day of illness persists fever, should begin receiving antimicrobials.
When the respiratory tract infections are used
- penicillin antibiotics (amoxiclav, Augmentin)
- macrolides (sumamed, klatsid)
- in severe disease may assignment cephalosporin (e.g., ceftriaxone intramuscularly or intravenously).
To facilitate the cough at laryngotracheitis necessary to conduct inhalation via nebulizer (this device need to have a home to everyone and use in disease in both adults and children). When a moderate course, you can use saline solution, wetting the mucous membranes of the respiratory tract by itself gives a positive effect. If this is not sufficient, it is possible to add a mucolytic (e.g. Mucosolvan for inhalation solution).
In the acute phase, with marked edema of airway (particularly in children) can use Pulmicort drug. It is a suspension for inhalation a dosage of 2 ml (1 mg), it must be diluted with saline in the ratio 1: 1, pour into a container for medicines inhalation nebulizer and hold, then rinse the mouth with water and to wash.
Orally applicable when coughing mucolytics: ACC, ACC-Long combined agents (e.g., syrup Codelac broncho-thyme)
Effectively physiotherapy: Electrophoresis drugs, Exposure to electric field ultrahigh frequency (UHF), physiotherapy, massage, low intensity laser radiation impact on the throat region.
Forecast at laryngotracheitis favorable, however, for people whose profession is connected with the singing, or the length of calls, laryngotracheitis may interfere with phonation, and cause prof. unfitness.
The section on the diagnosis and treatment of laryngotracheitis is written in accordance with the Federal standard
