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Laryngotracheobronchitis Croup (LTB) Infections Islamic University Nursing College

Laryngotracheobronchitis Croup (LTB) Infections Islamic University Nursing College. Stridor. It is the noise caused by obstruction of airflow due to narrowing in respiratory tract It may be inspiratory / expirator y

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Laryngotracheobronchitis Croup (LTB) Infections Islamic University Nursing College

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  1. LaryngotracheobronchitisCroup (LTB) InfectionsIslamic University Nursing College

  2. Stridor • It is the noise caused by obstruction of airflow due to narrowing in respiratory tract • It may be inspiratory /expiratory • Inspiratory stridor alone indicates that the lesion is at vocal cord level or above • An expiratory phase occurs when the tracheal lumen is also narrowed by oedema or inflammation

  3. Acute Laryngeal infections in childhood • Acute Epiglottitis • Laryngotrachealbronchitis • Bacterial Laryngotrachealbronchitis • Diphtheria • Conditions which like laryngeal infections

  4. Laryngotracheobronchitis (Croup) • As name suggests it involves larger proportion of respiratory tract (larynx, trachea, bronchi) • Area of maximum impact is sub-glottis • An acute illness with hoarseness, a barking cough, stridor and varying degree of respiratory distress • Affects young children (6 months to 3 years)

  5. In most cases causative organism is paramyxovirus, para-infleunza virus type I and type II • In adults it may also occur from herpes simplex, cytomegalovirus & influenza virus • Adult croup is rare, more severe & impaired immunity should always be considered • The key feature is sub-glottic oedema

  6. Symptoms: • Mostly occur suddenly at night. • Obstruction of airway • Mucus production. • Audible in-spiratory stridor. • Hoarseness of voice due to laryngeal edema • Fever.

  7. Investigations • Direct viral antigen detection by sampling mucus from nasopharynx • A plain neck radiograph may show narrowing of the subglottis (steeple sign) and ballooning of hypopharynx • Chest X-ray to exclude collapsed lobes or meditational shift

  8. Management • Oxygen, steroids and nebulized epinephrine should be administered • Monitor airway and oxygen saturation, consider endotracheal intubation if necessary • Broad spectrum antibiotics to cover secondary infection • No evidence to support antiviral agents

  9. Management in simple cases • Single dose of steroids. • Epinephrine is used in more severe cases. • Hospitalization rarely used. • Complications: Resipratoy distress, hypoxia

  10. Thank you

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