Resumo

RADA CUENTAS, Ademar Jaime. NEW CONCEPTS OF LARYNGOTRACHEITIS IN CHILDREN (VIRAL CROUP). Rev. Méd. La Paz [online]. 2023, vol.29, n.1, pp.87-103.  Epub 30-Jun-2023. ISSN 1726-8958.

The purpose of this update article is to provide information on the epidemiology, etiology, clinical manifestations for an accurate diagnosis, recommendations for requesting laboratory and cabinet tests, and finally symptomatic treatment with corticosteroids and when to use epinephrine or adrenaline. Laryngotracheitis (LT) is an acute respiratory infection triggered by a viral infection of the upper airway that affects 3% of children from six months to three years. It is responsible for 7% of annual hospitalizations for fever and / or acute respiratory illness in children under 5 years. It is the most frequent cause of obstruction of the upper airway, secondary to inflammation of the larynx, trachea and bronchi that causes respiratory stridor and barking cough. In most cases, the causative agent of the disease is the parainfluenza virus. While many children experience low-grade fever, their presence is not necessary for diagnosis, which is essentially clinical and laboratory and cabinet tests are rarely needed for this purpose. Viral culture and rapid test to identify antigens have minimal impact on treatment and are not recommended routinely. Radiography and laryngoscopy should be reserved when alternative diagnoses are suspected. The treatment is symptomatic with the usual use of corticosteroids and sometimes epinephrine or adrenaline. A single dose of oral, intramuscular or intravenous dexamethasone improves symptoms and decreases return visits, readmissions and length of hospitalization in children with LT of any severity. The addition of nebulized epinephrine improves symptoms in children with moderate or severe LT, decreases the percentage of intubation and prevents respiratory failure. Timely intervention at the onset of the disease, decreases the severity of symptoms, medical attention in pediatric emergency services and hospitalization.

Palavras-chave : RevSocBolPed2018; Croup; laryngotracheitis; laryngotracheobronchitis.

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