Laryngitis is an illness characterised by inflammation of the laryngeal mucosa (the voice box, where the vocal cords are). Depending of the length of the illness, laryngitis can be acute or chronic. If the illness lasts more than 3 weeks, it is a case of chronic laryngitis. In children, laryngitis is most commonly caused due to viral infections (adenoviruses, influenza viruses, coronavirus, etc.). Less often the reason may be bacterial and fungal infections or environmental factors of non-infectious nature, such as cigarette smoke, dust, smoke, allergens or reflux in babies. In older children and adults, laryngitis causes hoarseness or raspy voice and a dry, irritating coughing. In little children the so-called subchordal laryngitis develops and causes the airways in the larynx area to contract and hamper breathing. A typical onset of the illness is an episode at night, when the child suddenly wakes up and feels scared. The voice is changed – hoarse and raspy. Dry, “barking” coughing appears. The body temperature may also be increased. In more severe cases, a progressive shortness of breath is observed, as well as stridor (a specific noise that can be heard when the child is inhaling) and lips turning blue, often respiratory failure develops, which is a life-threatening condition and requires immediate medical attention. Unlike adults, in whom laryngitis does not cause serious conditions, children quickly develop severe illness and this is explained with some anatomic characteristic of the larynx – a narrow transverse section and an increased proneness to swelling.
Normally, viral infections are self-limiting and healed in about 5 – 7 days. Treatment is symptomatic. If body temperature reaches 38.5 С, antipyretics are given (ibuprofen, paracetamol, liquid analgin drops). The patient needs to leave their vocal cords to rest, fresh and humid air is recommended, because oxygen is extremely important in laryngitis treatment. Antihistamines are recommended only in cases of allergy, which rarely is the cause for laryngitis. Antibiotics are also not recommended, unless there is a proven bacterial infection. Inhalations with corticosteroids are done, which reduce the swelling of the larynx, which actually is the main reason for this condition. In more severe cases hospital treatment may be needed, where corticosteroids are applied intravenously or intramuscularly; additional corticosteroid medications may be taken orally; or the inhalations may be continued for a prolonged period. During the illness and in-between inhalations of corticosteroids, saline inhalations are also done.
What to do in case of laryngitis at home:
- Open the window so that cool and humid air can enter the room.
- Help the child calm down. Crying only makes the coughing worse and hampers breathing even more.
- If you have an inhalator, do one saline inhalation (NaCl 0.9%, 2 ml) and/or a corticosteroid inhalation – Budesonide (Pulmicort), 1 – 2 ml depending on the age. If there is no improvement, repeat the corticosteroid inhalation after 20 minutes.
When should we call a doctor:
- If the child is less than 1-year-old.
- If the breathing of the child is severely hampered, if you feel like it is “struggling to breathe”, or if the child’s lips are turning blue (perioral cyanosis).
- If the child keeps coughing severely, even after the corticosteroid inhalations done at home.