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Symptoms of acute laryngitis
Last reviewed: 04.07.2025
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Symptoms of acute laryngitis (false croup) usually develop on the 2nd-3rd day of acute upper respiratory tract infection and are characterized by hoarseness. Acute laryngotracheitis is accompanied by a loud "barking" cough. In the lungs - conductive dry wheezing, they are heard mainly on inhalation. The child is excited.
Acute stenosing laryngitis is characterized by a triad of symptoms - hoarseness, a ringing "barking" cough and noisy breathing - laryngeal stridor, which manifests itself mainly as inspiratory dyspnea. In addition, dry wheezing may be heard, mainly on inhalation. The child shows pronounced anxiety, is excited. The temperature reaction depends on the reactivity of the child's body and the causative agent of acute laryngitis. So, with parainfluenza etiology and RS-virus, the temperature reaction is moderate, with influenza etiology, the temperature is high. During the day, inspiratory dyspnea and the severity of airway obstruction vary from almost complete disappearance to pronounced, but are always maximally expressed at night.
[ Clinically, four degrees of laryngeal stenosis are distinguished.
- Grade I (compensated) is characterized by inspiratory dyspnea when the child is restless, a dry "barking" cough. Auscultation reveals an extension of inspiration, isolated wheezing in the lungs.
- Stage II (subcompensated) is characterized by the appearance of noisy breathing, inspiratory dyspnea at rest with retraction of the intercostal spaces and jugular fossa, hoarseness, "barking" cough. Scattered conductive dry wheezing is heard in the lungs, mainly on inhalation. The appearance of perioral cyanosis and tachycardia is characteristic. The child is excited, motor restlessness and sleep disturbance are noted.
- Grade III laryngeal stenosis (decompensated) is characterized by a rough "barking" cough, dysphonia, severe inspiratory dyspnea, retraction of the intercostal spaces, jugular fossa and epigastric region during breathing, and the appearance of paradoxical breathing. In prognostically unfavorable cases, dyspnea acquires a mixed character. Characteristic are tachycardia, frequent threadlike pulse, dropping out on inhalation, general cyanosis, confusion. Auscultation reveals moist and dry wheezing of various sizes both on inhalation and exhalation, and muffled heart sounds are determined.
- Stage IV (terminal) is characterized by confusion, hypoxic coma, and convulsions. Breathing is shallow and arrhythmic. Stridor and rough "barking" cough disappear. Bradycardia increases, arterial pressure decreases.
Complications of acute laryngitis
Stenosing acute laryngitis of II-III and III severity of viral genesis, due to the disruption of the breathing process, has a tendency to develop bacterial inflammation with the formation of fibrinous, fibrinous-purulent films, the spread of inflammation to the lower respiratory tract with the development of purulent laryngotracheitis, bronchitis and pneumonia.