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 DEFINITION
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The laryngeal stridency is a sign of respiratory difficulty in the children, which usually owes to an inflammation of the larynx and the trachea, which causes an occlusion to the step of the air along the airways, at level of the vocal cords. The laryngeal stridency can owe to itself to different viral or bacterial illnesses, chemical agents (caustic, irritating gases), physical reagents (gases or warm liquids), or allergies (angioedema or edema angioneurótico).
The croup or laringotraqueitis obstructive sharp, it is the most frequent cause of stridency laíngeo in children. It is an inflammation of the larynx and the trachea, of generally viral origin, which causes difficulty to breathe and noisy respiration. It is typical that the spasmodic croup is evident suddenly at dawn. The most frequent presentation age is between 1 and 5 years.
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CAUSES
The most frequent cause is viral (Parainfluenza, VRS, ADV, Measles). Other causes (bacteria, chemical or physical agents, allergies, etc) are less frequent.
CLINICAL SYMPTOMS
The child wakes up with difficulty to breathe and presents a very typical cough known popularly like the "dog's cough". It is frequent that previously the present child cold and later there shows the canine cough and the laryngeal stridency, which is when his respiration becomes noisy and difficult. The common thing is that it appears between October to March, although it appears in any season.
The clinical signs of laryngeal obstruction must be evaluated according to the following scale:
Grade I: Hoarseness (cough and voice), stridency inspiratorio light and intermittent, that is accentuated by the effort.
Grade II: Hoarseness (cough and voice), stridency inspiratorio continuous, light printing (withdrawal of the ribs)
Grade III: Hoarseness (cough and voice), stridency inspiratorio and espiratorio, intense printing, paleness, worry, sudoración, rapid respiration, etc
Grade IV: Phase of Agotarniento. Hoarseness, stridency, intense printing; paleness drowsiness, cianosis (bluish coloration of the skin); apparent decrease of the respiratory difficulty.
DISTINGUISHING DIAGNOSIS
- In the minor of 3 months: It is necessary to discard congenital malformations that they affect to the tree traqueobronquial (laringomalacia, etc).
- Catarrhal laryngitis: Nasal discharge and voice snores, without stridency or cough disfónica. Only it needs simple measurements.
- Laryngeal strange body: to suspect it opposite to sudden, day beginning or in laryngitis of atypical evolution.
- Epiglotitis (pseudocroup): Bacterial illness (for Haemophylus influenzae) of sudden beginning, high fever, the bad general state, pain and difficulty to swallow.
- Laryngeal diphtheria: Signs of laryngeal obstruction, with presence of a membranous exudado faringoamigdalino, adherent, ganglions in the neck, and the bad general state. The diphtheria is very rare nowadays due to the calendars vaccinate them current.
TREATMENT
It depends on the grade of laryngeal stridency.
- Grade I: If the child wakes up in the dawn with croup symptoms, it is necessary to put him to breathe the steam of the shower during 20 minutes, with the very warm water and later to put a humidificador in his room, with what often they improve quickly. Non-conducting type paracetamol in necessary case.
- Grades II, III and IV: They need treatment in First aid service, preferably hospitably. There will apply of gradual form nebulizaciones of adrenaline, corticoids IV, oxygen to themselves and even intubación endotraqueal.
If you suspect laryngeal stridency as symptom of croup in his son, call as soon as possible his pediatrician.
WHAT DOCTOR CAN TREAT ME?
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DEFINITION YOU 
