Laryngitis (Croup/Epiglottitis): Symptoms, Diagnosis, Treatment

Laryngitis is defined as an inflammation of the larynx, the organ found at the junction between the pharynx and trachea. This is the main organ of phonation, i.e. the ability to speak. The larynx contains two vocal cords as well as muscles and cartilage, all involved in the creation of sound. During laryngitis, the inflammation of the larynx prevents the passage of air.

Laryngitis can be acute, punctual, or chronic. Acute laryngitis is infectious and is overwhelmingly caused by a virus. It usually affects children, and is more common in adult men than women. Tobacco use, cold air breathing, and vocal abuse can also promote laryngitis.

In children under 2 years old, laryngitis is known as Croup, which affects the larynx, trachea (wind pipe), and bronchi (lungs). In children between the ages of 1 and 6 years old, severe laryngitis can cause sufficient swelling to cause airway obstruction and asphyxiation. This is called epiglottitis.


After an abrupt onset, acute laryngitis will cause: hoarseness in the voice; difficulty speaking; cough, classically described to sound like "barking"; tightness in the throat; breathing difficulties; difficulty eating and swallowing.

Symptoms in of croup children include: a harsh, barking, "croupy" cough, which is often worse at night; stridor, or noisy breathing when inhaling; hoarse voice; mild fever; shortness of breath; sore throat, pain when swallowing, and swollen neck glands;
tiredness as well as general aches and pains.

Symptoms of epiglottis include: difficult and noisy breathing; lack of crying; high fever; muffled voice; drooling saliva; hollow thorax when inhaling; sweaty, clammy and very pale or gray skin; and cyanosed (bluish) lips.


The diagnosis is frequently made, especially in children, by observing a characteristic cough or abnormal voice. It is done so without the need for any further examination.

Sometimes, it may be helpful to observe the larynx via a technical indirect laryngoscopy, with the help of a light reflected on a mirror placed into the mouth.


Treatment is symptomatic and can be done at home. It includes: resting the voice; limiting exposure to predisposing factors, like tobacco smoke and dust; anti-inflammatory drugs or corticosteroids; and antibiotics for any secondary infections.

In children, it is important to keep your child calm and to help them avoid becoming stressed as crying can make symptoms worse. Also keep your child upright as this can facilitate breathing.
Breathing in hot and humid air from water vapor for about 15 minutes may also provide relief.

In the case of acute epiglottitis, which is a localised infection of the supraglottic larynx and has a rapid onset, children should be admitted to the hospital to avoid airway obstruction.

It is important to treat any fever that may be present. Dress yourself or your child in cool light clothing, and apply a wet towel on your or your child's. Hydration is also key, as well as paracetamol or ibuprofen to reduce the fever.

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