Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis.
(17/52)
OBJECTIVE: As a consequence of evolving medical practice, the epidemiology of potentially life-threatening upper airway infections is changing. We report our experience over 9 years with viral croup, epiglottitis, and bacterial tracheitis. PATIENTS AND METHODS: We studied a retrospective case series of patients admitted to Vermont Children's Hospital with potentially life-threatening upper airway infections viral croup, epiglottitis, or bacterial tracheitis between 1997 and 2006. MEASUREMENT AND MAIN RESULTS: There were 107 patients with viral croup admitted to Vermont Children's Hospital, with 16 (15%) admitted to the pediatric intensive care unit. Three patients with croup (17% of pediatric intensive care unit admissions, 3% of total admissions) required intubation. There were no serious complications. Eighteen patients were admitted with bacterial tracheitis. Ninety-four percent (n = 17) were admitted to the pediatric intensive care unit. Eighty-three percent (n = 15) were intubated. Twenty-eight percent of patients (n = 5) developed serious complications. Two adolescent patients were admitted with epiglottitis. Both were intubated and recovered without complications. Of 35 patients admitted to the pediatric intensive care unit with these potentially life-threatening upper airway infections, 20 patients (57%) developed respiratory failure. Fifteen patients (75%) had bacterial tracheitis, 3 patients (15%) had viral croup, and 2 patients (10%) had nonclassic epiglottitis. CONCLUSIONS: Immunization against Haemophilus influenza type b and widespread use of corticosteroids for the treatment of viral croup have changed the epidemiology of acute infectious upper airway disease. As potentially life-threatening infections, viral croup and epiglottitis have been eclipsed by bacterial tracheitis. In this series, bacterial tracheitis was 3 times more likely to have caused respiratory failure than viral croup and epiglottitis combined. Bacterial tracheitis should be considered in children who present with acute life-threatening upper airway infection. (+info)
Detection of human bocavirus in Canadian children in a 1-year study.
(18/52)
Human bocavirus was detected by PCR in 65 (5.1%) of 1,265 respiratory specimens collected in 2002 and 2003 from the Stollery Children's Hospital from children <17 years of age. The spectrum of illness included upper respiratory infection, croup, bronchiolitis, and pneumonia with a prominence of cough and fever. (+info)
Humidified air inhalation for treating croup: a systematic review and meta-analysis.
(19/52)
BACKGROUND: Croup (laryngotracheobronchitis) is a common cause of upper airway obstruction in children. Treatment with humidified air was previously widely used and is still commonly recommended as home treatment. OBJECTIVE: To assess the efficacy of humidified air in the treatment of croup. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. REVIEW METHODS: We included randomized controlled trials with or without blinding. All studies treating children with a clinical diagnosis of croup with warm or cool humidified air delivered by steam or humidified tent whether inpatients, attenders at the Emergency Department or in the community were eligible. MAIN RESULTS: Three studies in emergency settings provided data on 135 patients with moderate croup for the main outcome (croup score). The combined results from 20 to 60 minutes in the three studies marginally favoured the treatment group with a weighted standardized mean difference of -0.14 (95% confidence interval = -0.75 to 0.47). No outcomes were significantly different between the groups. CONCLUSIONS: The croup score of children managed in an emergency setting with mild to moderate croup probably does not improve greatly with inhalation of humidified air. There is insufficient evidence to exclude either a small beneficial or a harmful effect. (+info)
Quality of care for common pediatric respiratory illnesses in United States emergency departments: analysis of 2005 National Hospital Ambulatory Medical Care Survey Data.
(20/52)
Guideline development process for the Health for Kids in the South East project.
(21/52)
Health for Kids in the South East (HFK) was a project funded by the Victorian Government Department of Human Services, Hospital Admission Risk Program. The project aimed to improve health outcomes for children in southeast Melbourne (Victoria) by building partnerships between child health clinicians and implementing best practice. (+info)
Evidence based guideline for the management of croup.
(22/52)
Croup is a common presentation in both the general practice and hospital emergency department setting. The relatively recent introduction of steroid use in the management of croup has resulted in decreased hospital admissions and improved outcomes for children. (+info)
Laryngeal foreign body mistreated as recurrent laryngitis and croup for one year.
(23/52)
Foreign body aspiration (FBA) is a common, dangerous problem among children of all ages. Laryngeal foreign bodies may present with less severe symptoms compared to lower respiratory tract foreign bodies, resulting in misdiagnosis, confusion and delay. We present the case of a 20-month-old girl with laryngeal foreign body unrecognized for one year. She was treated for recurrent laryngitis and infectious croup several times. A triangular-shaped, red plastic material with sharp edges was removed from the larynx by direct laryngoscopy. The clinical presentation and management are discussed. (+info)
Croup.
(24/52)
In this analysis we used BEACH (Bettering the Evaluation and Care of Health) encounters with children aged 0-14 years from January 2008 to December 2009. Croup was managed 276 times during that period (at 1.2% of 23 016 encounters with children in this age group). This suggests that croup is managed in general practice about 154,000 times per year nationally. (+info)