Diagnosis of acute laryngitis

Diagnosis of acute laryngitis is based on clinical data, with stenosing laryngitis - on the data of direct laryngoscopy.

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Laboratory diagnosis of acute laryngitis

In acute simple laryngitis, there is no need for laboratory testing.

With stenosing laryngitis, the acid-base state of the blood is determined and the peripheral blood is analyzed.

• The acid-base state of blood in the first stage is without significant changes.
• In the II stage, the partial pressure of oxygen in the blood is moderately reduced, the partial pressure of carbon dioxide is not changed.
• In the third stage, the partial pressure of oxygen is lowered, the pressure of carbon dioxide is increased, respiratory or mixed acidosis is noted. There is a decrease in oxygen saturation.
• In IV, terminal, stage marked acidosis. The oxygen saturation is sharply reduced.

In the analysis of peripheral blood in the I-II stages in the viral etiology of stenosing laryngitis, normal or slightly decreased leukocytosis and lymphocytosis are noted. In the third stage of stenosing laryngitis, there is a tendency to leukocytosis, neutrophilia and a shift of the formula to the left.

To decipher the etiology, serological diagnostic methods are used to determine specific antibodies (IgG and IgM) to various viruses and bacteria and the PCR method provided early collection of material from the oropharynx in the acute period of the disease to identify a wide range of respiratory viruses.

In cases of prolonged flow, with ineffectiveness of conventional therapies. It may be necessary to identify the mycoplasmal. Chlamydial or other infections. To this end, PCR diagnostics of swabs from the throat and / or nose are carried out and seeding of the pharynx and nose is separated into normal nutrient media and Saburo medium (for detection of mycoses).

Instrumental diagnostics of acute laryngitis

With a simple acute laryngitis, there is no need for instrumental research. With stenosing laryngitis, the main study is direct laryngoscopy.

• I stage of stenosis of the larynx is hyperemia and a small edema of the mucous membrane of the larynx.
• II stage - edema and infiltrative changes in the laryngeal mucosa. Narrowing the diameter of the larynx lumen to 50% of the norm.
• III stage - infiltrative and fibrinous-purulent changes in the laryngeal mucosa. The mucous membrane of the larynx reveals areas of hemorrhage. In the lumen of the larynx, purulent crusts, viscous mucus, are possible. Mucopurulent strands. The narrowing of the larynx of the larynx is 2/3 of the norm.
• IV stage - terminal - narrowing of the laryngeal lumen more than 2/3 of the norm.

Radiography of the thorax, paranasal sinuses, and neck organs plays an auxiliary role in differential diagnosis or suspected complications (pneumonia).

Differential diagnosis of acute laryngitis

Differential diagnosis is carried out primarily between the viral or conditionally pathogenic bacterial genesis of acute stenosing laryngitis with laryngeal diphtheria, which is characterized by a slow gradual increase in the clinical picture of obstruction, dysphonia, the transition of the process to nearby tissues, an increase in cervical lymph nodes. Bacteriological research is of decisive importance.

Allergic edema of the larynx, which develops in response to the effects of various allergens - inhalation, food and others - is characterized by the absence of signs of acute respiratory disease, the absence of fever and intoxication. In the anamnesis there are indications of allergic manifestations.

The foreign body of the larynx and trachea is the most common cause of asphyxia in young children. Characteristically, the signs of suffocation and coughing occur suddenly, during the day, while eating or playing a child. The child is frightened, restless. With a direct laryngoscopy, a foreign body is detected.

The initiated pharyngeal abscess also sometimes has to be differentiated with acute stenosing laryngitis. In contrast to the latter, it is characterized by the gradual onset of labored breathing against the background of severe intoxication and often expressed fever. Characteristic nasal voices, forced pose with the head thrown back, and when examining the pharynx, the swelling of the posterior pharyngeal wall is noted.

Finally, differential diagnosis must be carried out with acute epiglottitis - inflammation of the epiglottis and surrounding tissues of the larynx and pharynx. Epiglottitis is characterized by rapidly growing symptoms of difficulty breathing due to swelling of the epiglottis and cherpalodnagortan folds. Characterized by intolerable pain in the throat, a sense of suffocation, a choked voice and high body temperature. Observe drooling, dysphagia. Inspiratory dyspnea, noisy breathing. When examining the pharynx, edema and hyperemia of the epiglottis are seen. The tongue is displaced anteriorly, is swollen, the edema of the pharyngeal tissues is expressed.

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