OVERVIEW

What is pediatric acute laryngitis?

Pediatric acute laryngitis commonly affects children aged 6 months to 3 years. It is an acute inflammation of the laryngeal mucosa caused by respiratory infections, vocal overuse, inhalation of harmful gases, etc., and frequently occurs in winter and spring.

The onset of pediatric acute laryngitis is rapid, with main symptoms including hoarseness, barking cough, inspiratory stridor, and inspiratory dyspnea. The condition is usually more severe in children than in adults.

Early medical attention is essential. Under a doctor's guidance, corticosteroids should be used to reduce inflammation and maintain airway patency.

Is pediatric acute laryngitis common?

Yes.

SYMPTOMS

What are the common manifestations of pediatric acute laryngitis?

Acute laryngitis is often accompanied by fever. The most common symptoms include:

• Hoarseness: Initially mild, worsening as the condition progresses.

• Cough: A barking cough, resembling a "hollow" or "empty" sound.

• Inspiratory laryngeal stridor, and in severe cases, inspiratory dyspnea. The child may exhibit flaring nostrils and retractions (intercostal, suprasternal, or subcostal). If untreated, symptoms may progress to pallor, cyanosis, confusion, and eventually respiratory or circulatory failure.

What are the complications of pediatric acute laryngitis?

Recurrent acute laryngitis may lead to chronic laryngitis. It may also be accompanied by acute tracheobronchitis in children.

What severe consequences can pediatric acute laryngitis cause?

Untreated pediatric acute laryngitis may lead to asphyxia, laryngeal obstruction, or dyspnea, which can be life-threatening.

Due to the loose submucosal tissue in children's larynx and their smaller laryngeal cavity and glottis, inflammation can easily cause congestion and edema, leading to laryngeal obstruction. Therefore, pediatric acute laryngitis is often more severe than in adults. Delayed diagnosis may endanger the child's life.

CAUSES

What are the common causes of acute laryngitis in children?

Acute laryngitis in children is mostly caused by viral infections, but it can also result from bacterial infections. Common viruses include parainfluenza virus, influenza virus, and adenovirus. Common bacteria include Staphylococcus aureus, Streptococcus, and Streptococcus pneumoniae.

Acute laryngitis in children may also occur as a complication of acute infectious diseases such as measles and whooping cough.

Laryngitis can be caused by the following conditions:

• Common colds and other infections affecting the throat;
• Shouting or overstraining the vocal cords;
• Inhaling irritating chemicals, such as cleaning agents or gasoline.

Who is most commonly affected by acute laryngitis in children?

Acute laryngitis in children is most common in children aged 6 months to 3 years.

Is acute laryngitis in children contagious? How is it transmitted?

It is generally not contagious.

Acute laryngitis in children is not a nationally notifiable infectious disease, so patients do not need to be isolated. However, individuals with low immunity may become infected after contact with patients, so contact should be avoided as much as possible.

DIAGNOSIS

How to make a preliminary judgment of pediatric acute laryngitis?

When hoarseness and a "barking" cough occur after a cold or overuse of the voice, acute laryngitis should be considered in the child.

What tests are needed to confirm the diagnosis in children suspected of having acute laryngitis?

Based on medical history, clinical symptoms, and signs, doctors can make a preliminary diagnosis. Routine ENT examinations, such as pediatric laryngoscopy (including direct electronic or fiberoptic laryngoscopy and indirect laryngoscopy), are usually unnecessary due to the difficulty of cooperation in young children.

If the condition persists or worsens, doctors may opt for a chest X-ray to check for abnormalities in the lower respiratory tract, such as the trachea or lungs.

Which diseases are easily confused with pediatric acute laryngitis?

• Tracheobronchial foreign body: History of foreign body inhalation, severe coughing, difficulty breathing, etc., distinguishable by chest auscultation and X-ray.
• Laryngeal diphtheria: Rare nowadays; gray-white pseudomembranes visible on throat examination, with diphtheria bacilli detectable via smear and culture.
• Laryngospasm: Sudden onset without hoarseness or "barking" cough.

TREATMENT

Which department should I visit for pediatric acute laryngitis?

You can go to pediatrics, pediatric respiratory medicine, otolaryngology-head and neck surgery, or respiratory medicine. In case of severe complications, seek emergency care promptly.

What are the treatment methods for pediatric acute laryngitis?

• Early use of glucocorticoids or epinephrine to reduce laryngeal mucosal swelling.

• Maintain airway patency. For severe laryngeal obstruction unresponsive to medication, a timely tracheotomy is necessary.

• Supportive therapy, including fluid replacement to maintain water and electrolyte balance.

• Avoid exposure to harmful gases and dust; correct improper vocalization methods.

• Use antibacterial drugs if a bacterial infection is confirmed.

• Keep the child calm, avoid crying, reduce physical exertion, and alleviate breathing difficulties.

Can pediatric acute laryngitis resolve on its own?

Pediatric acute laryngitis can theoretically heal without treatment.

However, since the condition may progress rapidly in some children, early medical evaluation is recommended to determine whether treatment or observation is needed.

Are there any sequelae after treatment for pediatric acute laryngitis?

Generally, no sequelae occur after treatment for acute laryngitis.

However, if a child experiences recurrent acute laryngitis, improper vocal habits, or delayed/inadequate treatment leading to chronic laryngitis, vocal nodules or polyps may develop later.

Is follow-up necessary for pediatric acute laryngitis? How?

It is advisable to revisit an otolaryngologist. Once symptoms subside, the condition is considered resolved, and fiber laryngoscopy is usually unnecessary.

Can pediatric acute laryngitis be completely cured?

With proper treatment and addressing the underlying cause, pediatric acute laryngitis can fully recover.

Can pediatric acute laryngitis recur after treatment? What to do if it recurs?

Recurrence is possible.

If recurrence occurs, seek medical attention promptly for treatment.

DIET & LIFESTYLE

What should children with acute laryngitis pay attention to in diet and daily life?

• Avoid giving children spicy or irritating foods.

• Prevent children from shouting, overusing their voice, or coughing violently.

• Use a humidifier or sit with the child in the bathroom while running hot shower water to help soothe their throat.

• If the child has a fever, acetaminophen or ibuprofen can be used to reduce it, but avoid aspirin for children under 18.

• Encourage drinking plenty of fluids. For children over 1 year old, warm clear liquids (such as water, apple juice, or pear juice) can help relieve throat discomfort.

• For children over 1 year old, elevate their head with a pillow.

• Avoid smoking around the child.

• Monitor the child's condition closely. It's best to sleep in the same room to promptly detect any breathing difficulties.

PREVENTION

How to Prevent Acute Laryngitis in Children?

Avoid letting children talk for long periods or shout loudly. Take measures to prevent infections, including:

• Both adults and children should wash hands frequently with soap and water or alcohol-based hand sanitizer.

• Keep children away from other sick adults and children.

• Ensure all necessary vaccinations, including the flu vaccine, are administered. Parents caring for children should also get the flu vaccine.