Related Experiment Videos
Severe laryngotracheobronchitis complicating measles
J D Fortenberry1, M M Mariscalco, P T Louis
1Department of Pediatrics, Baylor College of Medicine, Houston, Tex.
Insights
Severe laryngotracheobronchitis is a frequent complication in young children hospitalized with measles, often linked to superinfections. Early airway assessment and intervention are crucial for managing this severe measles complication.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pulmonology
Background:
- Measles outbreaks can lead to severe respiratory complications.
- Laryngotracheobronchitis is a serious airway inflammation that can occur in children with measles.
Purpose of the Study:
- To determine the incidence of severe measles-related laryngotracheobronchitis.
- To evaluate factors associated with airway injury severity and its management in measles patients.
Main Methods:
- A clinical description of a patient series was conducted.
- 124 children (1 month to 19 years) admitted with measles were analyzed.
Main Results:
- 27 patients had significant laryngotracheobronchitis; 10 were unvaccinated.
- Six patients required endotracheal intubation for airway obstruction; two died from superinfection.
- Early laryngoscopy and bronchoscopy were associated with shorter airway support.
Conclusions:
- Severe laryngotracheobronchitis is common in measles patients under 2 years, potentially due to superinfection.
- Early diagnostic procedures and interventions like tracheostomy may reduce airway complication incidence.
Objective:
To determine the incidence of severe measles-related laryngotracheobronchitis in patients hospitalized during a recent measles epidemic and to evaluate factors associated with severity of airway injury and its management.
Design:
Clinical description of patient series.
Setting:
Children's hospital and county general hospital, Houston, Tex.
Patients:
One hundred twenty-four children (aged 1 month to 19 years) admitted with a diagnosis of measles.
Interventions:
None.
Measurements/Results:
Twenty-seven patients had significant laryngotracheobronchitis, including 10 who had not received appropriate immunization. Six patients required endotracheal intubation for relief of upper airway obstruction. The median age of patients requiring intubation was 12 months (range, 4 to 24 months). Two patients died of complications of superinfection. Two patients survived but required prolonged intubation. Two patients underwent early diagnostic laryngoscopy and bronchoscopy and required shorter artificial airway maintenance.
Conclusions:
Severe laryngotracheobronchitis frequently occurs in patients younger than 2 years hospitalized with measles and may be related to bacterial or viral super-infection. Early diagnostic laryngoscopy and bronchoscopy for injury assessment and possible endotracheal tube exchange are recommended and, in some severe cases, tracheostomy should be considered to shorten artificial airway maintenance and decrease the incidence of airway complications.