Etiopathogenesis, Clinical Features, and Management of Acute Laryngotracheobronchitis

Introduction

Acute laryngotracheobronchitis, commonly known as croup, is a viral infection affecting the upper and lower respiratory tract. It primarily occurs in children and is characterized by inflammation of the larynx, trachea, and bronchi.

Etiopathogenesis

The condition is most commonly caused by parainfluenza viruses, particularly types 1 and 2. Other viral pathogens include respiratory syncytial virus (RSV), adenovirus, and influenza virus. The infection leads to mucosal inflammation, subglottic edema, and airway obstruction.

Clinical Features

Symptoms

• Barking cough
• Stridor (high-pitched breathing sound)
• Hoarseness
• Respiratory distress
• Fever

Diagnosis

Diagnosis is primarily clinical, based on characteristic symptoms. Imaging, such as neck X-rays, may show the classic 'steeple sign' indicating subglottic narrowing.

Management

Supportive Care

• Humidified air
• Hydration
• Antipyretics for fever

Pharmacological Treatment

• Corticosteroids (e.g., dexamethasone) to reduce inflammation
• Nebulized epinephrine for severe cases

Hospitalization Criteria

Patients with severe respiratory distress, hypoxia, or worsening symptoms may require hospitalization for close monitoring and advanced airway management.

Conclusion

Acute laryngotracheobronchitis is a common pediatric respiratory condition that requires prompt recognition and appropriate management to prevent complications. Early intervention with corticosteroids and supportive care significantly improves outcomes.