ro13-9904 and Croup

Topics: Administration, Intravenous; Anemia, Hemolytic; Ceftriaxone; Child, Preschool; Contraindications; Croup; Dexamethasone; Drug-Related Side Effects and Adverse Reactions; Erythrocytes; Female; Hemolysis; Humans; Immunosuppression Therapy; Parainfluenza Virus 2, Human; Steroids

To describe the first case of a group A beta-hemolytic streptococcus laryngotracheobronchitis as well as the other possible etiologies in a case of acute dyspnea.. We report the case of a 46-year-old woman with a doubtful vaccination status who presented clinical features of croup (laryngotracheobronchitis). She developed respiratory distress and required endotracheal intubation.. The endoscopy demonstrated a great deal of crust and pseudomembrane detachment. Bacterial culture grew group A beta-hemolytic streptococcus. Progression was good with antibiotics and corticosteroid treatment.. Bacterial acute pseudomembranous croup (laryngotracheobronchitis) is rare. We must search for the most frequent diagnoses such as diphtheria and epiglottitis. This is the first case to be reported in the literature.

Topics: Acute Disease; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Bronchitis; Ceftriaxone; Ciprofloxacin; Croup; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Laryngitis; Laryngoscopy; Methylprednisolone; Middle Aged; Streptococcal Infections; Streptococcus pyogenes; Time Factors; Tracheitis; Treatment Outcome

Larnygeotracheobronchitis is a common disease of childhood most often associated with infection by parainfluenza virus. Although rare, adult cases have been reported. Adult croup presents similarly to the childhood version; however, the severity is usually much worse, often leading to hospitalization. Presented is the case of an 80-year-old woman with croup, which is the twelfth reported in the English literature.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Ceftriaxone; Croup; Female; Humans

We present a case of bacterial tracheitis in a 6.5 year old girl. Clinical signs and symptoms consisted of severe croup with high grade fever, which were preceded by upper respiratory tract prodrome. Initial treatment with steroids and nebulized epinephrine was unsuccessful. The patient was intubated a few hours after admission. Thick purulent secretions emerging from the trachea and the normal appearance of the epiglottis suggested the diagnosis of bacterial tracheitis, which was confirmed by isolation of Haemophilus influenzae in the culture of the tracheal secretions. The patient was administered a 14 day course of endovenous ceftriaxone and was kept on mechanical ventilation for 7 days. Fever and purulent tracheal secretions continued for the next 5 days. After 48 hours without these signs, laryngotracheobronchoscopy ruled out residual obstruction. Extubation was successfully performed. Fourteen days later physical examination showed no abnormalities and the patient was discharged. No complications were found during followup. The clinical, diagnostic and therapeutic aspects of this potentially life threatening entity that should taken into account in the differential diagnosis of severe croup are discussed.

Topics: Ceftriaxone; Cephalosporins; Child; Croup; Female; Follow-Up Studies; Haemophilus Infections; Haemophilus influenzae; Humans; Respiration, Artificial; Time Factors; Tracheitis