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[Croup in children--results of prospective, multicenter observation]
Leszek Szenborn1, Jerzy Pejcz, Henryk Szymański
1Klinika Chorób Zakaźnych Dzieci, Akademii Medycznej we Wrocławiu. szenborn@zak.am.wroc.pl
Insights
Subglottic laryngitis is the most common cause of croup in children. Epiglottitis, though rare, can be severe, highlighting the importance of the Hib vaccine for preventing life-threatening cases.
Area of Science:
- Pediatric infectious diseases
- Respiratory illnesses in children
Context:
- Croup syndrome frequently necessitates pediatric hospitalization.
- Understanding the etiological and clinical spectrum of croup is crucial for effective management.
Purpose:
- To prospectively analyze the causes and clinical presentations of croup syndrome in hospitalized children.
- To evaluate the severity and outcomes of different croup diagnoses, including epiglottitis.
Summary:
- Subglottic laryngitis was the most frequent diagnosis (75.4%) among 632 children with croup syndrome.
- Epiglottitis occurred rarely (3%) but presented with the most severe course, requiring intubation in some cases.
- The incidence of epiglottitis was comparable to pre-Hib vaccine era rates, suggesting the vaccine's preventive impact.
Impact:
- Findings underscore subglottic laryngitis as the primary cause of pediatric croup.
- The study emphasizes the continued risk of severe epiglottitis and the critical role of routine Haemophilus influenzae type b (Hib) vaccination in prevention.
Unlabelled:
Croup syndrome is an urgent and frequent reason for hospitalization of children.
Material And Methods:
632 children with croup syndrome (422 boys and 210 girls aged 2 months-17 years) admitted to 15 pediatric departments in Lower Silesia were prospectively observed for 12 months (from April 2001 to March 2002). We conducted prospective survey of clinical and laboratory data from all study centers.
Results:
Following diagnoses were accepted as the croup syndrome: subglottic laryngitis in 482 patients (75.4%), laryngotracheobronchitis in 75 (11.8%), laryngitis in 50 (7.8%) and epiglottitis in 20 children (3%). The most severe course was observed in children with epiglottitis. Four of them required airway intervention and had endotracheal intubation. H. influenzae b was cultured from blood of one patient. The most cases of epiglottitis occurred in the 3rd year of life (45%).
Conclusions:
1. The most common reason of croup was subglottic laryngitis. 2. Epiglottitis was rare with serious course of disease; frequency was comparable with the frequency seen in European countries before the implementation of Hib vaccine. The routine use of Hib vaccine in Poland may prevent from children life threatening epiglottis cases.
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