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Emergency Medicine
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Stridor is an inspiratory noise related to obstruction of the extrathoracic airway. Dynamic intrathoracic airway obstruction can also result in expiratory stridor in conditions such as bronchomalacia or tracheomalacia. Obstruction of the extrathoracic airway is most commonly due to acute conditions such as viral laryngotracheitis (Fig. 1.1), bacterial tracheitis (Fig. 1.2), foreign body aspiration (Figs 1.3–1.5) and other conditions such as quinsy, retropharyngeal abscess (Fig. 1.6), epiglottitis (Fig. 1.7), inhalation of hot gases and angioneurotic oedema. Airway obstruction can also occur as a result of chronic lesions such as subglottic or tracheal stenosis (Fig. 1.8), vascular rings (Fig. 1.9), airway haemangiomata (Fig. 1.10) and polyps. These may present in the context of an intercurrent viral infection which may make the airway obstruction worse.
Infectious Disease: Upper Respiratory Infections and Otitis Media
Published in Hilary McClafferty, Integrative Pediatrics, 2017
In children, the symptoms of URI are often observed in the lower part of the respiratory tract. Usually laryngotracheitis is noticed in this age group, which features a series of symptoms such as dry cough, hoarseness, loss of voice, barking or deep cough, gagging, and thick mucus secretion. Upper respiratory tract infection symptoms are usually seen to last for a period of 3 to 14 days (Bosch et al. 2013).
Overview of Human Upper and Lower Respiratory Tract Viral Infections
Published in Sunit K. Singh, Human Respiratory Viral Infections, 2014
Fleur M. Moesker, Pieter L.A. Fraaij, Ab D.M.E. Osterhaus
Laryngotracheitis is a condition in which the mucosa is inflamed and swollen up in the area of the larynx and the vocal cords, sometimes extending to the trachea and even to the bronchi. An almost pathognomonic symptom of viral laryngotracheitis (VLT) in young children is the “seal-like” barking cough.35,46 In older children and adults, this distinct cough is less pronounced or may not occur at all.46 Other important symptoms are inspiratory stridor, and hoarseness, accompanied by fever and malaise. Parainfluenza type 3 and influenza viruses are the most frequent causes of VLT,35,38,46 although other viruses, such as HMPV and RSV, may also be involved.47,48 Inflammation of the larynx and trachea is usually mild and self-limiting, but considering the location, life-threatening airway obstructions can occur.35,46 Patient management should focus on safeguarding the airway passage. The treatment consists of the reduction of local edema by means of using corticosteroids (including dexamethasone) and sometimes nebulized epinephrine.49–53 On the basis of population-based studies, fewer than 5% of children with VLT are admitted to the hospital, although in severe cases, intensive care treatment may be required.35,46,54
First report of Enterobacter asburiae isolate, producing NDM-1 and a novel ACT-68 enzyme in Bulgaria
Published in Infectious Diseases, 2019
Rumyana Markovska, Temenuga Stoeva, Petya Stankova, Lyudmila Boyanova, Dobromira Dimitrova, Rayna Gergova, Ivan Mitov
The isolate was recovered from blood culture of a 5-year-old child, admitted to the paediatric ward of the hospital with acute laryngotracheitis in June 2017. The identification and antimicrobial susceptibility testing were done by the automated Phoenix system (Becton Dickinson, Franklin Lakes, NJ). The isolate was identified as E. cloacae complex interpreted according to the guidelines of EUCAST, 2018. The isolate demonstrated a multidrug-resistant profile. It was nonsusceptible to ampicillin >8 mg/L, cefuroxime >8 mg/L, ceftazidime >8 mg/L, cefotaxime >4 mg/L, amoxicillin/clavulanate >8/2 mg/L, piperacillin/tazobactam >16/4 mg/L, cefepime 16 mg/L, imipenem >8 mg/L, meropenem >8 mg/L, tobramycin >4 mg/L, gentamicin >4 mg/L, amikacin >32 mg/L, aztreonam >16 mg/L, ciprofloxacin 0.5 mg/L, trimethoprim/sulfamethoxazole >4/76 mg/L and colistin >4 mg/L. Susceptibility was found only to tigecycline 0.38 mg/L, levofloxacin 0.25 mg/L, nitrofurantoin <16 mg/L and fosfomycin <16 mg/L. The phenotypic confirmation of carbapenemase production was performed by the modified Hodge test and KPC/Metallo-beta-lactamase and OXA-48 Confirm Kit (ROSCO Diagnostica A/S, Taastrup, Denmark). The isolate showed a weakly positive Hodge test and an inhibition of the carbapenem-hydrolysing activity by dipicolinic acid, thus indicating MBL-production.
Chicken toll-like receptors and their significance in immune response and disease resistance
Published in International Reviews of Immunology, 2019
Aamir Nawab, Lilong An, Jiang Wu, Guanghui Li, Wenchao Liu, Yi Zhao, Qimin Wu, Mei Xiao
Various other research also described that when CpG combined with H4N6 (LPAI A/Duck/Czech/56), H5N1 (H5N1 oil emulsion vaccine), or H5N2 (A/Ostrich/Denmark/72420/96) influenza vaccines had increased levels of secretory IgA, serum IgG and reduced production of IFN-α, IFN-ϒ and IL-8 [54, 98, 126]. Furthermore, in ovo administration of CpG Oligodeoxynucleotides (CpG ODN) to the chicken embryo had decreased in ovo replication of H4N6 AIV (avian influenza virus) and infectious bronchitis (IB) virus [127, 128, 156–158]. The treatment showed protective effects against infectious laryngotracheitis in hatched chicks [159].
Eyedrop vaccination: an immunization route with promises for effective responses to pandemics
Published in Expert Review of Vaccines, 2022
Jihei Sara Lee, Sangchul Yoon, Soo Jung Han, Eun-Do Kim, Jiyeon Kim, Hae-Sol Shin, Kyoung Yul Seo
So far, most extensively investigated mucosal vaccines are those administered via oral and intranasal routes. The first oral vaccine was demonstrated in a murine model, in which sublingual administration of live-attenuated Japanese encephalitis virus led to the activation of virus-specific CD4 and CD8 T cells [22]. In 1962, an oral vaccine against poliomyelitis virus was licensed. Since then, notable advances have been made [23], and a number of oral vaccines have shown considerable success. A clinical trial of an oral vaccine against adenovirus types 4 and 7 demonstrated a sero-conversion rate of approximately 94% [24]. A vaccine against Vibrio cholerae has successfully been developed and commercialized as Vaxchora for individuals between the age of 18 and 64 years [25]. Rotarix and RotaTeq are available for oral immunization against rotavirus [26–28]. Although they are in general believed to be highly safe and effective, their use in children, especially those under the age of 2 years, have been questioned in the past because of the incomplete safety data [21]. Nasal administration has also been examined as an alternative route for mucosal vaccines. The intranasal route is attractive because it bypasses the acidic condition of the gastrointestinal tract and digestive enzymes like pepsin. Immunization through the nose has successfully provided protection in animal models against the Ebola virus, encapsulated pneumococci, influenza virus, and Yersinia pestis, just to name a few [29–32]. A couple of nasal vaccines against the human influenza virus was approved for commercial use: FluMist in the United States and Nasalflu in Switzerland [33]. The simple administration and cost-effectiveness of mucosal vaccines have also attracted the attention of veterinary medicine. Ocular, oral, and intranasal mucosal vaccines have widely been used to protect chickens from infectious laryngotracheitis virus (ILTV) for decades [34,35]. Mucosal delivery of M. haemolytica and those bacteria in the Pasteurellaceae family has been attempted in cattles [36]. The concept of mucosal vaccines has also been proposed for fish such as Atlantic salmon [37]. The development of effective mucosal vaccines remains a topic of active investigation in both human and veterinary medicine.