Acute infectious epiglottitis is infrequent at present due to vaccination for its main etiologic agent, Haemophilus influenzae b Hib. It must be taken into account when we make a differential diagnosis in a child whose clinical symptoms are respiratory distress, stridor, dysphonia and fever. We report a 2-year-old child, previously healthy, whose vaccination calendar was complete, and whose clinical presentation included respiratory distress and stridor; at the moment of the intubation the laryngoscopy showed an acute epiglottitis. Blood cultures were taken, which were positive for Hib. He was treated with ceftriaxone during 13 days, and the control blood cultures and cerebrospinal fluid were negative.
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Lubianca Neto 1 , Gilberto B. Fischer 2 , Fernanda D. Peduzzi 3 , Humberto L. Junior 3 , Rita C. Krumenauer 3 , Vinicius T.
A maior parte dos pacientes avaliados veio da unidade de tratamento intensivo. I ntroduction : Abnormalities of the airway often present with stridor. The main cause in neonates and infants are the congenital defects of the larynx. The specific etiologic diagnose can be just obtained through fibronasolaryngobroncoscopy, which is necessary for the correct management of this children. Study design : Clinical prospective and descriptive cross-sectional study.
Aim : To describe the main causes and associated clinical findings of stridor in children presenting to our hospital. These patients were examined according to a priori defined protocol, which includes besides questions about history, physical examination and associated comorbities, a standard fibronasolaryngobroncoscopy examination. Results : A group of children 69 male and 56 female were evaluated. The mean age at inclusion was 19 months. Most patients came from intensive care unit.
Almost all cases had comorbidities, long-term endotracheal intubation been the most common finding. Conclusions : Even in the presence of a more select sample than the great international series, we also found congenital anomalies of the larynx as the main cause of stridor.
It was difficult to differentiate between congenital and acquired subglottic stenosis in some cases with a history of endotracheal intubation. The presence of comorbidities is frequent and may help to select the patients who will need endoscopic evaluation. Key-words: stridor, fibronasolaryngobroncoscopy, congenital anomalies of the larynx. A Tabela II compara os dados aqui obtidos com os de Holinger 1 em lactentes abaixo de 30 meses. O tratamento da ES pode ser expectante nos casos menos severos, pois a maioria dos pacientes resolve os sintomas com o crescimento.
Grande parte dos pacientes foi oriunda da UTI do hospital, representando casos extremos de estridor. Holinger LD. Etiology of Stridor in the Neonate, Infant and Child. Ann Otol Rhinol Laryngol ; Congenital Anomalies of the Larynx. In: Practical Pediatric Otolaryngology.
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Yellon RF. Am J Med ; 5A : Halstead LA. Gastroesophageal reflux: A critical factor in pediatric subglottic stenosis. Otolaryngol Head Neck Surg ; Artigo recebido em 31 de janeiro de All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal. How to cite this article.
[Epiglottitis Due to Haemophilus Influenzae Type B in the Vaccination Era: Pediatric Clinical Case]
Regina H. Martins I ; Norimar H. Dias II ; Emanuel C. Trindade IV. Os resultados foram apresentados de forma descritiva e em percentuais, sendo confrontados com os dados da literatura. Para Rocha et al. Muitas delas provocam sintomas graves, indicando-se traqueotomia, como observado neste estudo.