Acute inflammatory upper airway obstruction.

Abstract

The most common cause of acquired acute airway obstruction is usually acute inflammation below or above the level of the vocal cord. Since a child's larynx is not merely a miniature of the adult's one, symptoms are quite different from those of an adult case even if the lesion is the same. The clinical status of the patient, age, physical signs, the patient's behavior, and history of the disease provide clues to make the precise diagnosis. Radiologic evaluation has no place in the diagnosis of laryngeal inflammation.Although very rare in children, acute epiglottitis is a potentially mortal disease and all children with this disease need an artificial airway and should be managed urgently and meticulously. On the other hand less than 10% of both acute epiglottitis in adults and acute laryngotracheitis in children needs an artificial airway. Bacterial tracheitis, usually secondary to acute laryngotracheitis, is also a life-threatening disease and patients often need tracheotomy.Eleven-month-old girl with acute laryngotracheitis, 4-year-old boy with acute epiglottitis, 75-year-old male with acute epiglottitis, and 57-year-old female with bacterial tracheitis secondary to acute laryngotracheobronchitis are discussed.