Lviv clinical bulletin 2014, 4(8): 30-33

https://doi.org/10.25040/lkv2014.04.030

Clinical and Laboratory Characteristic of Acute Stenosic Laryngotraceitis in Children Hospitalized into Diagnostic Department of Lviv Regional Hospital of Infectious Diseases during the year 2013

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O. Hladchenko

Danylo Halytsky Lviv National Medical University

Introduction. Infectious diseases of respiratory organs in children today are one of the most important problems of pediatrics. According to statistics, acute respiratory viral infections (ARVIs) occupy a leading place in the structure of the morbidity of children. The importance of this problem lies in the fact that 1.0-5.0% of children of early age with acute respiratory infections are accompanied by acute stenotic laryngotracheitis syndrome (ASLS), in case of which the risk of an unfavorable course of the disease is significantly increased in early childhood.

Aim. According to the results of a retrospective study, to study the peculiarities of the course of acute stenotic laryngotracheitis in children aged 0.0-60.0 months, which were treated in the Lviv Regional Infectious Diseases Clinical Hospital during 2013.

Material and methods of research. The analysis of 391 medical records of children aged 0.0-60.0 months (117 girls and 274 boys) who underwent inpatient treatment in the 1st diagnostic department of the Lviv Regional Infectious Diseases Clinical Hospital, with the diagnosis “Acute respiratory viral infection, acute stenotic laryngotracheitis” from January, 1 to December, 31, 2013. The patients were divided into three groups, depending on the severity of the stenosis of the larynx, which was recorded at the time of the hospitalization of the patients. 104 children with stenosis of the larynx of the 1st degree entered into the first group, 271 patients with stenosis of the larynx of the 2nd degree –  into second group, 17 patients with stenosis of the 3rd degree – into third group. For the analysis there were taken the data from the case history, the severity of the condition at the time of hospitalization, results of complete blood count, bacteriological examination of the mucus from the oral cavity, the presence and nature of the complications, and the treatment that was taken.

Results The age of children with ASLS, which caused stenosis of the larynx of the third stage, was 36.7 ± 5.91 months. It was significantly higher than the age of patients with stenosis of the larynx of the I-II degree. The results of bacteriological examination of mucus from the upper respiratory tract revealed virtually the same spectrum of isolated microorganisms in patients of I and II, in children of the III group, the microorganisms were allocated much less frequently. The frequency of excretion of bacteria from the upper respiratory tract did not depend on the presence and type of complications that arose in children with acute stenotic laryngotracheitis. The lack of probable interconnections between the changes in the complete blood count and the results of the bacteriological examinations provides the grounds for treating leukocytosis and increasing of the level of bands as a reaction of macroorganisms to stress, hypoxia, possibly with the administration of the high doses of glucocorticoids, rather than bacterial factors.

Conclusions. Respiratory complications unrelated to the presence of microorganisms in the upper airways and peripheral blood changes mainly reflect the child’s reaction to stress and treatment with corticosteroids.

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