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te laryngitis
• N asal irrig ation w ith 0 .9 % sod ium ch lorid e or R ing er L actate, 4 to 6 tim es/ d ay to
clear th e airw ay.
• A n antih istam ine m ay be g iv en for 3 d ays (prom eth azine P O or ch lorph enam ine
PO ,
see pag e 1 1 7 ).
• IndecxhamildetrheansowneiIthM :se0v.1eretod0y.s2pnmoeag:/ kg as a sing le d ose
or hydrocortisone I M : 1 m g / kg as a sing le d ose
2 case: progressive onset dyspnoea (over more than 24 hours)
nd
– Viral subglottitis: th e onset is frequently nocturnal, th e d yspnoea is typical, th e cry
and coug h h av e a raucous sound , but expiration is unobstructed .
• M onitor th e ch ild , try to keep h im calm . H av e h im breath e in a h um id env ironm ent
(near a bow l of w ater or w et tow el).
• dexamethasone IM : 0 .1 to 0 .2 m g / kg or hydrocortisone I M : 1 m g / kg , to be repeated
after 3 0 m inutes if necessary
• A ntibiotics are not useful, except in cases of second ary infection ( am oxicillin or
cotrim oxazole).
• In case of d eterioration: intubation if possible, or, failing th at, trach eotom y.
Note: exclud e d iph th eria (see Diphtheria, pag e 5 5 ) and retroph aryng eal abscess.
Adults
– U sually v iral: treatm ent is sym ptom atic (paracetam ol or acetylsalicylic acid P O ).
– V ery rarely, epig lottitis d ue to Haemophilus influenzae, d iph th eria or retroph aryng eal
abscess: sam e clinical sig ns and treatm ent as for ch ild ren.
– A lso consid er laryng eal tuberculosis in a patient w ith tuberculosis, or cancer of th e
larynx, particularly if th e patient sm okes.
52
• N asal irrig ation w ith 0 .9 % sod ium ch lorid e or R ing er L actate, 4 to 6 tim es/ d ay to
clear th e airw ay.
• A n antih istam ine m ay be g iv en for 3 d ays (prom eth azine P O or ch lorph enam ine
PO ,
see pag e 1 1 7 ).
• IndecxhamildetrheansowneiIthM :se0v.1eretod0y.s2pnmoeag:/ kg as a sing le d ose
or hydrocortisone I M : 1 m g / kg as a sing le d ose
2 case: progressive onset dyspnoea (over more than 24 hours)
nd
– Viral subglottitis: th e onset is frequently nocturnal, th e d yspnoea is typical, th e cry
and coug h h av e a raucous sound , but expiration is unobstructed .
• M onitor th e ch ild , try to keep h im calm . H av e h im breath e in a h um id env ironm ent
(near a bow l of w ater or w et tow el).
• dexamethasone IM : 0 .1 to 0 .2 m g / kg or hydrocortisone I M : 1 m g / kg , to be repeated
after 3 0 m inutes if necessary
• A ntibiotics are not useful, except in cases of second ary infection ( am oxicillin or
cotrim oxazole).
• In case of d eterioration: intubation if possible, or, failing th at, trach eotom y.
Note: exclud e d iph th eria (see Diphtheria, pag e 5 5 ) and retroph aryng eal abscess.
Adults
– U sually v iral: treatm ent is sym ptom atic (paracetam ol or acetylsalicylic acid P O ).
– V ery rarely, epig lottitis d ue to Haemophilus influenzae, d iph th eria or retroph aryng eal
abscess: sam e clinical sig ns and treatm ent as for ch ild ren.
– A lso consid er laryng eal tuberculosis in a patient w ith tuberculosis, or cancer of th e
larynx, particularly if th e patient sm okes.
52
