Pediatric acute laryngitis occurs in children aged 6 months to 3 years. Compared to adults, pediatric acute larynx has its own peculiarities and is prone to respiratory distress. The main reasons are that the laryngeal cavity is narrower in children, and the swelling can easily lead to obstruction of the vocal cords; the submucosal tissue of the larynx is loose, and the lymphatic tissue and glands are abundant in children, so the laryngeal cavity is easily swollen and narrowed during inflammation; the cartilage of the larynx is soft in children; the cough reflex is poor in children, and secretions from the trachea and larynx are not easily discharged; the resistance and immunity of children to infection are weak, and the inflammatory response is heavy; children are prone to laryngospasm, etc. Etiology】 Often secondary to upper respiratory tract infections, such as acute rhinitis, pharyngitis; can also be secondary to some acute infectious diseases, such as influenza, measles and pertussis. Most of them are caused by viruses, which provide the conditions for secondary bacterial infections after the invasion. The infecting bacteria are mostly Staphylococcus aureus, Streptococcus b, S. pneumoniae, etc. Pathology】 The lesion mainly occurs in the subsonic cavity, and the inflammation may involve the trachea downward. The mucosa of the subsonic cavity is edematous, and in severe cases, submucosal cellulitis, purulent or necrotic changes may occur. The mucosa can be extensively defective due to ulceration, and it is rare to have pseudomembrane formation on the surface. Clinical manifestations] 1. Systemic symptoms The onset of the disease is rapid, and there may be fever, general malaise, malaise, etc. 2. 2. Hoarseness The hoarseness is not serious at the beginning, but gradually increases as the disease worsens. 3. Coughing There is often a paroxysmal “empty” “empty” cough (also often a “barking” cough). 4. Dyspnea As the disease worsens, symptoms of persistent laryngeal obstruction, such as croupy cough and inspiratory stridor, may appear. Severe hoarseness, frequent coughing, dull coughing and growling may also appear suddenly at night. In severe cases, there is significant depression of the supraclavicular fossa, intercostal space, suprasternal fossa and epigastric region during inspiration, cyanosis or irritability, and slowed breathing, or shallow and rapid breathing in the late stage. If the disease develops further, there may be cyanosis, cold sweat, pale face, respiratory weakness, and even respiratory and circulatory failure, coma, convulsions, and death. The laryngeal mucosa is congested and swollen, the vocal cords turn pink or red, and sometimes mucopurulent secretions can be seen; the subglottis mucosa is swollen and bulges toward the middle. Laryngoscopy is rarely performed clinically because the pediatric patient cannot cooperate. Blood oxygen saturation monitoring is performed when necessary. Diagnosis】 The disease is rapid in onset and development, and if not diagnosed in time, it can lead to the risk of death. Therefore, children with hoarseness and “empty” “hollow” cough should be thought of this disease immediately when encountered clinically. The diagnosis can be made if there is inspiratory laryngeal wheeze and inspiratory dyspnea. Laryngoscopy is rarely performed because of the uncooperative nature of the child. Differential diagnosis】 1. Foreign body in the tracheobronchial tube Most of them have a history of foreign body aspiration, with symptoms such as violent choking and coughing, dyspnea and cyanosis. Chest physical examination, X-ray examination and bronchoscopy can help in the differential diagnosis (see Chapter 21 of Part IV for details). 2, laryngeal diphtheria is an infectious disease caused by Corynebacterium diphtheriae, with an incubation period of 1-7 days, mostly 2-4 days. Laryngeal diphtheria often extends from pharyngeal diphtheria. The onset of the disease is slow, the dry cough is bark-like, hoarse, and can cause inspiratory dyspnea and laryngeal stridor. This disease can be seen in the pharynx gray-white pseudomembrane, attached to the mucosa is not easy to fall off, can be found in the pseudomembrane smear and culture bacillus diphtheria. 3, pediatric laryngospasm Common in younger infants. Inspiratory laryngeal wheezing, the tone of voice is sharp and thin; there may be inspiratory dyspnea; no barking cough, no hoarseness. The onset is short and the symptoms may disappear suddenly. 4, other should be noted with measles, chicken pox, whooping cough, scarlet fever and mumps and other infectious diseases are now differentiated. Treatment】 Pediatric acute laryngitis is a life-threatening emergency, once diagnosed, effective measures should be taken immediately to relieve respiratory distress. The key to treatment is to lift the laryngeal obstruction, early use of effective, adequate antibiotics and glucocorticoids. 1.Antibiotics and glucocorticoids Early use of adequate antibiotics to control the infection and glucocorticoids to reduce and eliminate the swelling of the laryngeal mucosa. Antibiotics such as penicillin and cephalosporins can be used. According to the condition, use intramuscular injection or intravenous drip glucocorticoids (such as dexamethasone). 2.Supportive treatment includes oxygen, antispasmodic, sputum, ultrasonic nebulized inhalation, and transnasal oxygen. Pay attention to systemic nutrition and water-electrolyte balance, protect cardiopulmonary function, and avoid acute cardiac insufficiency. Rest quietly and reduce crying to lower oxygen consumption and reduce respiratory distress. 3.Tracheotomy If there is severe laryngeal obstruction and the patient does not improve with medication, tracheotomy should be performed in time.