Clinical characteristics and principles of therapy of stenosing laryngotracheitis in young children with acute respiratory infections

Abstract

Objective. To study the clinical characteristics and principles of therapy of acute stenosing laryngotracheitis in young children with acute respiratory infection (ARI). Materials and methods. A clinical study was conducted on 30 children aged 1 to 7 years with ARI and acute stenosing laryngotracheitis hospitalized in the Dushanbe City Clinical Hospital of Pediatric Infectious Diseases in October–December 2020. The diagnosis was confirmed by PCR; 53.3% of patients had influenza, 26.7% had parainfluenza, 13.3% had respiratory syncytial virus infection, and 6.7% had adenovirus infection. Results. All patients presented with catarrhal symptoms for 1–3 days, accompanied by subfebrile fever in 23.3% patients and febrile fever in 66.7% children. The onset of the disease in all children was sudden, with the appearance of signs of stenosing laryngotracheitis mainly in the evening and at night and rapid progression in the duration of the attack, from several minutes to 1-2 days. The majority of young children with ARI (22/73.3%) were noted to have the second degree of stenosing laryngotracheitis with characteristic stenotic breathing, sleep disturbance, periodic agitation and an increase in all clinical symptoms at rest, 5 (16.7%) children were observed to have the first degree with mild hoarseness and periodic «barking» cough, and 3 (10%) children with the third degree of stenosing laryngotracheitis were admitted to the intensive care unit in a serious condition with constant dyspnea, severe anxiety, alternating with lethargy, drowsiness, as well as a sharp hoarse voice, up to aphonia. All children were prescribed recombinant interferon-alpha-2b with antioxidants (VIFERON®) as part of combination therapy at an age-appropriate dosage of 150,000 IU, one suppository twice daily, for a 5-day course. Conclusion. Stenosing laryngotracheitis in young children with acute respiratory infection most often occurred in the second and third stages (83.3%), with pronounced signs of acute respiratory failure (66.7%).