The preferred localization of influenza infection is the mucosa of the upper respiratory tract and larynx. Usually, the manifestation of influenza in the larynx region occurs in the form of catarrhal inflammation, but in more severe forms of influenza, hemorrhagic laryngitis is often observed, manifested by submucous hemorrhages, or fibrinous-exudative laryngitis with marked exudation of fibrin and ulceration of the mucosa. In young children, severe laryngotracheobronchitis occurs. With influenza laryngitis more often than with other acute inflammatory processes, there are abscesses and phlegmon of the larynx, localized in the epiglottis or aryepiglotti folds, in which the leading etiological role is played by streptococci.
Symptoms and clinical course. The general condition is typical for severe influenza infection, which is dominated by a headache, general weakness, joint pain and calf muscles, high body temperature, etc. Local symptoms differ little from those of banal laryngitis. A cough at the beginning of the disease is dry, causing pain behind the sternum (trachea injury), then accompanied by abundant secretions of mucopurulent sputum. Characteristic for influenza laryngitis laryngoscopic changes occur only in the herpetic form, in the remaining cases - as in banal catarrhal laryngitis with slightly more hyperemia of the mucosa. Sometimes there is a massive swelling of the larynx and marked hyperemia, which may indicate the onset of the ulcerative necrotic form of influenza laryngitis.
Functional disorders are manifested by dysphonia, with swelling - obstruction of the respiratory function of the larynx.
The diagnosis is based mainly on a general clinical picture, much more severe than with a common catarrhal laryngitis. This picture is supplemented by hemorrhagic phenomena in the mucous membrane of the larynx.
Treatment of influenza laryngitis is local - the same as with banal acute or complicated laryngitis. In addition, pulverization and inhalation of an aerosol of anti-influenza lyophilized and hyperimmune serum, anti-influenza remantadine, antipyretic drugs, B vitamins, ascorbic acid, calcium preparations, diphenhydramine and other antihistamines are used.
The prognosis for usual influenza laryngitis is favorable. In severe forms of influenza, the prognosis is determined by a toxic syndrome, often ending lethal, especially with influenza haemorrhagic pneumonia.
Prevention is to exclude contact with SARS patients during influenza epidemics.
Etiology. Usually, when measles laryngitis occurs, the measles virus affects the entire respiratory tree, so the larynx disease is only a particular case of the general inflammatory process of the upper and lower respiratory tract.
Symptoms and clinical course of measles laryngitis. In the initial stage, there is an enanthema of the laryngeal mucosa, and when an exanthema (skin rashes typical for measles) appears on the mucosa, disseminated spots appear, after which there remain small surface erosions covered with pseudomembranous plaque, the origin of which is due to secondary infections.
With the appearance of raids and ulcers, hoarseness of voice arises, barking painful cough, mucopurulent sputum is secreted. However, the clinical course and evolution of the disease proceed favorably and only in rare cases complications such as edema, croup, and phlegmon of the larynx can occur.
Treatment of measles laryngitis is similar to that prescribed for acute banal laryngitis. In addition, anti-measles vaccines, serums, phages, vitamins (retinol, retinol palmitate), antiviral agents (inosine pranobex, isoprinosine, ribavirin, flacoside) are used. Prevention: avoiding contact with children with measles.
Laryngitis with chicken pox
Laryngitis with chickenpox is catarrhal in nature, and only in rare cases on the mucous membrane of the larynx appear vesicles at the same time with the same rashes on the skin. These vesicles turn into rounded sores. There may also be hemorrhagic forms of measles laryngitis accompanied by pronounced edema, draining ulcers and filmy deposits. Such forms can be complicated by phlegmon, perichondritis, and stenosis of the larynx.
Scarlet fever of larynx
With scarlet fever, light forms of laryngitis can be observed simultaneously with the onset of scarlet fever enanthema. Often laryngitis with scarlet fever remains unnoticed. In rare cases, like ulcerative necrotic scarlet fever can occur phlegmonous laryngitis and perichondritis as complications in the activation of opportunistic microbiota (superinfection). In some cases, the defeat of scarlet fever infection is of a total nature, in which lesions of the pharynx, larynx, trachea, and esophagus occur. The condition for such complications is the state of immunodeficiency in HIV infection, deep avitaminosis, blood diseases, etc.
Treatment. Conventional catarrhal forms of scarlet latin laryngitis do not require special treatment: those therapeutic measures that are applied to the general disease are sufficient. In this case, appoint: macrolides and azalides (azithromycin, zitrolide, sumazid, chemomycin, oleandomycin, etc.), penicillins (benzathine benzylpenicillin, retarpen, etc.), cephalosporins (cefaxime, ceftibutene).