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Severe upper airway obstruction caused by ulcerative laryngitis.

M Hatherill1, L Reynolds, Z Waggie

  • 1Paediatric Intensive Care Unit, Institute of Child Health, Red Cross War Memorial Children's Hospital, Klipfontein Road, Cape Town, 7700, South Africa. hatheril@ich.uct.ac.za

Archives of Disease in Childhood
|September 25, 2001
PubMed
Summary

Severe ulcerative laryngitis can cause upper airway obstruction in children. Early microlaryngoscopy is recommended for children with croup showing atypical symptoms, as this condition is more common than previously thought.

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Area of Science:

  • Pediatric Intensive Care
  • Pediatric Otolaryngology
  • Pediatric Infectious Diseases

Background:

  • Severe upper airway obstruction in children often presents as croup.
  • Ulcerative laryngitis is a rare but serious cause of airway compromise.
  • The incidence and clinical course of ulcerative laryngitis in pediatric populations require further elucidation.

Purpose of the Study:

  • To describe the experience with severe upper airway obstruction due to ulcerative laryngitis in children.
  • To identify the incidence and clinical characteristics of ulcerative laryngitis in a pediatric intensive care unit (PICU) setting.
  • To evaluate the diagnostic utility of microlaryngoscopy in suspected cases.

Main Methods:

  • Retrospective case note review of 263 children with severe upper airway obstruction and croup diagnosis admitted to a PICU over five years.

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  • Microlaryngoscopy was performed on 148 children.
  • Clinical data, including coexistent ulcerative gingivostomatitis and outcomes, were analyzed.

    • Main Results:

    • Fifteen children (10%) were diagnosed with ulcerative laryngitis.
    • Ulcerative laryngitis was more frequent in children with ulcerative gingivostomatitis (33%) compared to those without (5%).
    • Nine children required nasotracheal intubation and five required tracheostomy; all 15 children survived.

    Conclusions:

    • Ulcerative laryngitis is a more prevalent cause of severe upper airway obstruction in this pediatric cohort than previously reported.
    • Early diagnostic microlaryngoscopy is crucial for children with severe croup exhibiting atypical presentations.
    • Prompt diagnosis and management can lead to favorable outcomes even in severe cases.