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BACKGROUND: SARS-CoV-2 infection in pediatrics has a range of clinical presentations. Cases of laryngotracheitis during the Pandemic and the Omicron variant could affect the severity. SARSCoV- 2 infection in pediatrics has a range of clinical presentation manifestations. OBJECTIVE: To analyse and compare the characteristics of laryngotracheitis in pediatric patients with and without active SARS-CoV-2 infection in 2020-2022, as well as the severity of the clinical picture. MATERIAL AND METHOD: Observational, cross-sectional study of 86 patients aged 0-16 years with laryngotracheitis with or without SARS-CoV-2 infection. RESULTS: 70.9% were male and 29.1% female, with a peak age of 1-5 years (73.2%). The peaks of laryngotracheitis were in January 2020, June 2021, and December 2022. Thirty-nine patients positive for SARS-CoV-2 (73%) were identified out of the fifty-three tested. Infection did not influence severity. Conclusion: SARS-CoV-2 infection does not seem to affect the severity of acute laryngotracheitis in children, although it does affect its rebound due to the circulation of the omicron variant. [ABSTRACT FROM AUTHOR]

Introduction. Researching on pathogenesis and immunopathogenesis of acute respiratory infections in conjunction with recurrent episodes of acute laryngotracheitis and otorhinolaringological diseases (tonsillopharyngitis, rhinosinusitis, otitis) — is a high priority task for pediatrics, what is necessary to do to create an approach for preventing chronic illnesses.The aim of the present work. Researching on clinical and immunological characteristics and efficiency of treatment with prescription of bacterial lysate (OM-85) for children with recurrent episodes of acute laryngotracheitis, acute respiratory infections (ARI), otorhinolaringological diseases.Materials and methods. Fifty children 3-9 years old (32 children 3-6 years, 18 children 7-9 years old; 32 boys, 28 girls) in the initial period of monitoring, with recurrent episodes of acute laryngotracheitis (ALT), acute respiratory infections (ARI), otorhinolaryngological diseases were examined. The treatment in according with pediatric clinical practice guidelines, consultations with a pediatrician, otorhinolaryngologist, allergologist were provided to all children.Twenty five children (subgroup I b) received bacterial lysate (OM-85, 4 courses in 3 years ) in complex treatment. Subgroups I a, I b were similar in clinical symptoms, gender and age related. Follow up period continued three years. The results were evaluated a year and three years after treatment. Experimental group was composed of 30 children 3-9 years old, additionally examined. This group had such characteristics as: frequency of acute respiratory infections 3-5 times in a year, absence of chronic respiratory diseases, of recurrent episodes of acute laryngotracheitis. Immunological survey included some parameters of innate immunity, serum immunoglobulins, chemiluminescence, interferons (IFN-alfa, IFN-gamma).Results. In children with repeated episodes of ALT and ARI and otorhinolaryngological diseases the expression of TLR2 and TLR4 on CD14+ cells, receptors for IFN-γ (CD14+CD119+) is significantly higher than in children without ALT and with a frequency of ARI 3-5 times a year, which is accompanied by a decrease in the level of IFN-γ and IFN-α and is associated with the development of dysregulation of the immune system, which decreases with the administration of bacterial lysate (OM-86). Complex treatment of children within 3 years with the prescription of the drug significantly reduces the frequency of ARI — 2.6 times, tonsillopharyngitis — 1.8 times, rhinosinusitis — 2.2 times, the need for the prescription of antibiotics — 2.2 times. In the group treated by standards after 3 years, the need for antibiotics decreased by 1.6 times, the frequency of ARI exacerbations — by 1.2 times, tonsillopharyngitis — by 1.5 times, rhinosinusitis — by 1.8 times.

The Omicron variant of SARS-CoV-2 has a predilection for the upper airways, causing symptoms such as sore throat, hoarse voice, and stridor. We describe a series of children with COVID-19–associated croup in an urban multicenter hospital system. We conducted a cross-sectional study of children ≤18 years of age presenting to the emergency department during the COVID-19 pandemic. Data were extracted from an institutional data repository comprised of all patients who were tested for SARS-CoV-2. We included patients with a croup diagnosis by International Classification of Diseases, 10th revision code and a positive SARS-CoV-2 test within 3 days of presentation. We compared demographics, clinical characteristics, and outcomes for patients presenting during a pre-Omicron period (March 1, 2020–December 1, 2021) to the Omicron wave (December 2, 2021–February 15, 2022). We identified 67 children with croup, 10 (15%) pre-Omicron and 57 (85%) during the Omicron wave. The prevalence of croup among SARS-CoV-2–positive children increased by a factor of 5.8 (95% confidence interval 3.0–11.4) during the Omicron wave compared to prior. More patients were ≥6 years of age in the Omicron wave than prior (19% vs. 0%). The majority were not hospitalized (77%). More patients ≥6 years of age received epinephrine therapy for croup during the Omicron wave (73% vs. 35%). Most patients ≥6 years of age had no croup history (64%) and only 45% were vaccinated against SARS-CoV-2. Croup was prevalent during the Omicron wave, atypically affecting patients ≥6 years of age. COVID-19–associated croup should be added to the differential diagnosis of children with stridor, regardless of age. © 2022 Elsevier Inc. [ABSTRACT FROM AUTHOR]

Background: Croup encounters substantially decreased when the pandemic first began, specifically between March and September 2020, before croup cases dramatically spiked again with the Omicron variant. There is a dearth of information concerning children at risk for severe or refractory COVID-19-associated croup and their outcomes. Objective: The objective of this case series was to describe the clinical characteristics and outcomes of croup associated with the Omicron variant in children, with a focus on cases refractory to treatment. Methods: The case series includes children from birth to 18 years old who presented to a freestanding children's hospital emergency department in the Southeastern United States between December 1, 2021 and January 31, 2022 with a diagnosis of croup and a laboratory-confirmed diagnosis of COVID-19. We used descriptive statistics to summarize patient characteristics and outcomes. Results: Of the total 81 patient encounters, 59 patients (72.8%) were discharged from the ED, with one patient requiring two revisits to the hospital. Nineteen patients (23.5%) were admitted to the hospital, and three of these patients represented to the hospital after discharge from the hospital. Three patients (3.7%) were admitted to the intensive care unit, none of whom represented after discharge. Conclusions: This study reveals a wide age range of presentation as well as a relatively higher rate of admission and fewer coinfections compared to pre-pandemic croup. Reassuringly, the results also show a low postadmission intervention rate as well as a low revisit rate. We discuss four refractory cases to highlight nuances for management and disposition decisions.

Bacterial diseases of the upper respiratory tract accompanied with various degrees of clinical signs are relatively frequent in a small animal clinical practice. The clinical signs are usually mild, mostly connected with clinical manifestation of nasal discharge, mild dyspnoea, sneezing, and coughing; however, in some cases they may convert to a chronic stage with serious systemic manifestations. The course and development of complications depends on the etiological agent and the success or failure of the subsequent therapy. An accurate diagnosis is of the upmost importance in order to develop an appropriate therapeutic plan for disease management. The present study focused on: endoscopic visualisation of the upper respiratory tract of the affected animals; localisation of pathological changes, and the targeted collection of the samples. This clinical study involved 26 patients with long-term signs of the affected airways that progressed to chronic stages after the failure of the prescribed therapy. Each patient was clinically examined, sedated and subjected to an endoscopic examination that involved the collection of samples. The samples were examined microbiologically, tested for antibiotic resistance, and a targeted therapy was implemented. The endoscopic and complex microbiological diagnosis enabled: more effective management of the bacterial infection; shortening of the therapy; and a convalescence period that reduced the risk of the development, or the spreading of resistant bacteria.

Aim: To evaluate the experience of NETS (The Newborn and paediatric Emergency Transport Service) New South Wales (NSW) with children referred with a provisional diagnosis of croup. To examine the adherence of referral hospitals to NSW Health policy guidelines and to establish criteria for the need to transfer and the level of escort required for a child with croup to a higher level of care. Methods: A retrospective audit of all children with a provisional diagnosis of croup referred to NETS over the epoch: 2005–2015. The NETS database was searched for keywords: croup and laryngotracheitis. Demographics, retrieval characteristics and management strategies were collected. Results: A total of 432 patients were identified. The number of children triaged to a medically led NETS team for transfer decreased (P < 0.001) whilst those transferred into more local regional or metropolitan hospitals (P < 0.001) increased. The number of adrenaline doses was not associated with intensive care admissions or the need for invasive ventilation. Conclusion: Medically led retrieval teams are not necessary for safe transfer of children with a provisional diagnosis of croup unless the airway is secured with an endotracheal tube. Transfer to more local hospitals for paediatric care should be considered and time allowed for medications to take effect prior to movement. [ABSTRACT FROM AUTHOR]

A clinical conditions resembling infectious laryngotracheitis were diagnosed amongst 20,000 , 18,000 , 16,000 and 17,500 respectively, 28-30 weeks old, ISA brown layers. The hens had nasal discharges, moist rales, coughing and gasping. Hemorrhagic mucous was ejected during sneezing, lacrirnation, conjunctivitis with facial swelling with eyes partially or completely" closed. Postmortum examination of dead and affected hens revealed hemorrhagic tracheitis with thin pseudomembrane formation. The larynx, congested with petechia on mucous membrane, Infraorbital sinus contained clear thick fluid. Histopathological examination of trachea showed hypertrophy, of epithelial pseudostratification of the mucosal cell surface, extensive hemorrhages and desquamative necrotizing tracheitis with mononuclear cells infiltration. Multinucleated gaint cells in theciliated epithelium containing round, oval shaped intranuclear A inclusion bodies. The lamina propiia shows edema, marked‘ congestion with lymphocytic infiltration.A presumptive diagnosis of laryngotracheitis was made.

Background and Aim: Infectious laryngotracheitis (ILT) of chickens is a substantial issue to be studied in Iraq because this disease is one of the most highly contagious respiratory diseases in the world caused by a herpesvirus. However, in Iraq, the ILT virus (ILTV) infection and disease have yet not been confirmed in layers, so farm owners do not vaccinate these layers. The current study aimed to document the detection and characterization of ILTV in layer hens from Al-Diwaniyah city, for the first time in Iraq, using molecular techniques like polymerase chain reaction (PCR) and sequencing. Materials and Methods: Four layer farms (15,000 unvaccinated layers/farm) in Al-Diwaniyah province, Iraq, suffered a severe ILT outbreak, was diagnosed and reported by clinical and PCR tests. This disease has been reported in Iraq, and more recently, it began to show outbreaks in Al-Diwaniyah city. The current work opted to investigate the ILTV using PCR and DNA sequencing techniques. The study targeted the p32 gene of ILTV using pooled tracheal swabs and organs including the trachea, lung, and kidneys which were collected from dead and clinically infected chickens. Results: The analyses revealed that four of six suspected field samples showed positive results by PCR. The DNA sequencing results showed the homology of the amplified fragments with the studied gene. Conclusion: This study confirmed the presence of ILTV in hens with respiratory signs during the outbreak.

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ABSTRACT: Infectious laryngotracheitis (ILT), caused by an Alphaherpesvirus (Gallid herpesvirus-1; GaHV-1), has been noticed in the region of the Terras Altas da Mantiqueira, Minas Gerais. From 2010 to 2018, the “Serviço Veterinário Oficial” (SVO) of the “Instituto Mineiro Agropecuário” (IMA), implemented measures to prevent spread of the virus to other regions and control the disease in the area. Due to the close proximity and consequent epidemiological link among farms, the region was considered a unique epidemiological unit. To check the efficiency of the ILT control measures, we carried out: (1) a seroepidemiological survey, (2) questionnaires for evaluating biosecurity measures; and (3) an evaluation of the influence of farm population density on the occurrence of ILT. In 2016, 2017, and 2018, ILT was investigated using epidemiological and clinicopathological methods, along with GaHV-1 molecular detection. Serological survey was carried out on 24 farms in the quarantined region and on 13 farms from other regions of the state. In 2010 and 2018, questionnaires were applied to collect data and determine indicators of biosecurity practices in all farms of the quarantined area. The differences were then assessed (Wilcoxon’s p

Background: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research. [ABSTRACT FROM AUTHOR]

Objective of the research was to study the frequency of stenosing laryngotracheitis (LT) and recurrent stenosing laryngotracheitis (RLT) incidences in children depending on ambient air pollutants concentration. Methods. The concentrations of suspended sediments, sulfur dioxide, carbon monoxide, nitrogen dioxide, hydrogen fluoride, ammonia, and formaldehyde in Vinnytsia within 1508 days (2000–2004) have been analyzed. All medical emergency calls caused by LT diagnosis (1–3 episodes of the disease) and RLT diagnosis (4 and > episodes of the disease) in children aged 0–14 years have been studied. Results. It has been established that a level of the atmospheric air pollution in Vinnytsia had been consistently high mainly due to formaldehyde, hydrogen fluoride and suspended sediments. The 1178 incidences of LT and 72 incidences of RLT were registered. The number of daily incidences of LT and RLT ranged from 0 to 6 and from 0 to 2, respectively. The average daily concentrations and daily 20-minute maximum concentrations of nitrogen dioxide and hydrogen fluoride in air were higher on days with LT incidences than on days without LT incidences. The average concentrations of nitrogen dioxide and hydrogen fluoride during the observation period exceeded the maximum permissible average daily concentrations. The average of 20-minute maximum of nitrogen dioxide and hydrogen fluoride concentrations during the observation period did not exceed the maximum permissible single exposure concentrations. Direct weak correlations have been revealed between LT incidences in children and daily average concentrations and 20-minute maximum concentrations of nitrogen dioxide and hydrogen fluoride in air. It hasn’t been revealed correlations between LT incidences and ambient air pollution by suspended sediments, sulfur dioxide, carbon monoxide, ammonia and formaldehyde. There were no significant differences in average concentrations and 20-minute maximum concentrations of air pollutants between days with RLT incidences and days without RLT incidences. Conclusions. The correlations between LT and ambient air pollution by nitrogen dioxide and hydrogen fluoride have been established. No correlation between RLT and air pollutants has been revealed.

This case report details an atypical etiology of laryngotracheitis (croup) in a three-year-old child diagnosed with coronavirus disease 2019 (COVID-19). Unlike typical croup cases, the patient required hospitalization and multiple administrations of racemic epinephrine for respiratory distress. The author highlights the importance of considering COVID-19 (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) as a potential etiology of croup in children. This distinction is crucial as such cases may necessitate more intensive medical intervention and prolonged monitoring compared to standard croup treatment protocols. The patient reported here did not require intensive care admission or respiratory support., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ali et al.)

Objective: To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis.Study Design: Case series with literature review.Setting: Tertiary children's hospital and available literature.Subjects and Methods: Case series of children with bacterial tracheitis retrospectively reviewed at a tertiary children's hospital. Those with a tracheostomy or those who developed bacterial tracheitis as a complication of prolonged intubation were excluded.Results: Thirty-six children were identified (mean ± SD age, 6.7 ± 4.5 years). The most common presenting symptom was cough (85%), followed by stridor (77%) and voice changes/hoarseness (67%). A concurrent viral illness was found for 55%, and the most common bacteria cultured was methicillin-sensitive Staphylococcus aureus. Pediatric intensive care admission occurred for 69%, and 43% required intubation. No patient required tracheostomy. One patient (2.7%) died secondary to airway obstruction and subsequent respiratory arrest. Four patients had recurrence of bacterial tracheitis 4 to 12 months following their initial presentation.Conclusion: Bacterial tracheitis is an uncommon condition with an atypical presentation and variable clinical course but serious consequences if left unrecognized. Staphylococcus is the most common bacteria identified, and many patients will have a prodromal viral illness. Changes in patient epidemiology and presentation may have occurred over time. [ABSTRACT FROM AUTHOR]

Laryngotracheobronchitis, commonly known as croup, is a respiratory illness, often mild, which occurs most frequently in children between six months and three years of age. It is characterised by a seal-like 'barking' cough, hoarseness of the voice and inspiratory stridor which is preceded by fever, rhinorrhoea and a non-specific cough. Respiratory distress and lethargy are uncommon exacerbations of croup which may be potentially life threatening. This article provides an overview of croup, including the epidemiology and clinical manifestations and the management thereof. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine how cytokine transcription profiles correlate with patterns of infectious laryngotracheitis virus (ILTV) replication in the trachea, Harderian gland, and trigeminal ganglia during the early and late stages of infection after intratracheal inoculation. Viral genomes and transcripts were detected in the trachea and Harderian gland but not in trigeminal ganglia. The onset of viral replication in the trachea was detected at day one post-infection and peaked by day three post-infection. The peak of pro-inflammatory (CXCLi2, IL-1β, IFN-γ) and anti-inflammatory (IL-13, IL-10) cytokine gene transcription, 5 days post-infection, coincided with the increased recruitment of inflammatory cells, extensive tissue damage, and limiting of virus replication in the trachea. In contrast, transcription of the IFN-β gene in the trachea remained unaffected suggesting that ILTV infection blocks type I interferon responses. In the Harderian gland, the most evident transcription change was the early and transient upregulation of the IFN-γ gene at 1 day post-infection, which suggests that the Harderian gland is prepared to rapidly respond to ILTV infection. Overall, results from this study suggest that regulation of Th1 effector cells and macrophage activity by Th1/2 cytokines was pertinent to maintain a balanced immune response capable of providing an adequate Th1-mediated protective immunity, while sustaining some immune homeostasis in preparation for the regeneration of the tracheal mucosa. [ABSTRACT FROM AUTHOR]

Introduction. One of the most common syndromes in pediatrics is stenotic laryngotracheitis (SLT), in which genesis has a leading role in viruses, and is also characterized by certain seasonal rhythms. In contrast to SLT, recurrent stenotic laryngotracheitis (RSL) is considered by some authors as a polyphaktorial disease in which pathogenesis has chronic allergic inflammation with respiratory tract hyperuricaemia, immunological disorders, genetic predisposition and persistence of some pathogens (viruses of influenza, parainfluenza, adenoviruses, respiratory-syncytial viruses (rs-viruses), chlamydia). Aim. To study (on the results of long-term observation) the monthly dynamics of the occurrence of SLT and RSL compared to the analogical dynamics in case of the presence of respiratory viruses. Materials and methods. The analysis of cases of SLT (1-3 episodes of the disease) and RSL (4 episodes of the disease and more) was performed in a cohort of children 1995-1999 years of birth for the period 1995-2008 in Vinnitsa on the basis of materials of the Ambulance Station and the Regional Clinical Infectious Disease Hospital. The spectrum of respiratory viruses (virus viruses, paraghirs, adenoviruses, rs-viruses), was detected by the direct immunofluorescence analysis (ELISA) in smears from the nasal mucosa in children with SLT and RSL. Results. It was found out that the cases of SLT occurred during the year with the highest rate in March and October, and with the lowest rate in the summer months. Unlike the SLT fluctuations the RSL fluctuations were less pronounced, with a peak in October and with a fall in May, July and August. Parainfluenza viruses were dominated among the pathogens identified in patients with SLT and RSL. The curve of monthly dynamic of the cases of SLT coincided with the curve of the dynamic of positive results of immunofluorescent assay on parainfluenza viruses. These data indicated a dominant role of parainfluenza viruses in the genesis of SLT. Dynamics of the cases of RSL coincided with the dynamics of parainfluenza viruses only in October (peak), and with the dynamics of all detected viruses in March (increase) and in July (decrease). There were no clear patterns between the curves of respiratory viruses and the curve of RSL in the other months. These data indicated the significant role of other factors in the development of RSL. Conclusions. Parasitic viruses play a decisive role in the genesis of SLT. The peak of the monthly dynamics of cases of RSL (October) coincided with the rise of the curve of the dynamics of the parainfluenza virus.

Chronic cough is associated with repetitive injury to the upper airway and trachea, which can lead to an underdiagnosed pathology known as “cough-induced” laryngotracheitis (CILT). In this report, we describe a case of CILT that responded well to dual therapy.

Three different extubation procedures were compared in 31 patients with acute stenotic laryngotracheitis. The influence of each method on extubation components, such as inflammation, stress, allergy, by eosinophilic changes and glycemia and cortisol levels, was evaluated. The proposed extubation procedure was found to have an advantage over traditional ones.

Marek’s disease virus (MDV) is a herpesvirus that induces lymphomas and immunosuppression in chickens. MDV-induced immunosuppression (MDV-IS) is divided into two phases: early-MDV-IS occurring mainly in chickens lacking maternal antibodies (MAb) against MDV and associated with lymphoid organ atrophy; and late-MDV-IS occurring once MDV enters latency and during tumour development. Our objectives were to document the impact of late-MDV-IS on commercial poultry (meat-type chickens bearing MAb against MDV and that were vaccinated or unvaccinated against MD) and to optimize a model to study late-MDV-IS under laboratory conditions. The impact of late-MDV-IS was evaluated by assessing the effect of early infection (day of age) with a very virulent plus MDV (vv+MDV) on the efficacy of chicken-embryo-origin (CEO) infectious laryngotracheitis (ILT) virus vaccine against ILT challenge. The CEO ILT vaccine was administered in water at 14 days of age and ILT virus (ILTV) challenge was done intratracheally at 30 days of age. Development of ILT was monitored by daily evaluation of clinical signs, development of gross and histological lesions in trachea, and quantification of ILTV transcripts in trachea. Infection with vv+MDV strain 648A resulted in total abrogation of protection conferred by the CEO vaccine against ILTV challenge even in chickens vaccinated at 1 day of age with either HVT, HVT+SB-1, or CVI988. Chickens exposed to vv+MDV prior to vaccination with CEO ILTV vaccine had similar (P < 0.05) clinical scores, gross lesions, histopathologic lesion scores, and load of ILTV transcripts in trachea after ILTV challenge, as chickens that were not vaccinated with CEO ILTV vaccine. [ABSTRACT FROM AUTHOR]

Infectious laryngotracheitis (ILT) herpesvirus continues to cause outbreaks of respiratory disease in chickens world-wide. Sporadic cases of ILT occur in all classes of birds, including hobby/show/game chickens, broilers, heavy breeders, and commercial laying hens. These epornitics of ILT tend to occur where there are large populations of naïve, unvaccinated birds, i.e., in concentrated areas of broiler production. ILT virus can be transmitted through (a) chickens with acute upper respiratory tract disease, (b) latently infected "carrier" fowls, and (c) fomites and contaminated persons. Chicken flocks which are endemic infected with ILT virus occur only in some regions of countries or even in particular multiple-age production farms. In these cases modified live vaccines are actually used, even though these biological products, as well as wild ILTV strains, can establish latent infections. In the case of heavy breeders and laying hens, which are typically vaccinated against ILT, sporadic cases are often related to errors in vaccine application and to biosecurity failures.

Infectious laryngotracheitis is a highly contagious disease of chickens responsible for significant economic losses for the poultry industry worldwide. The disease is caused byGallid herpesvirus-1(GaHV-1) commonly known as the infectious laryngotracheitis virus. Although characterized by their potential to regain virulence, chicken embryo origin (CEO) vaccines are the most effective vaccines against laryngotracheitis as they significantly reduce the replication of challenge virus in the trachea and conjunctiva. Knowledge on the nature of protective immunity elicited by CEO vaccines is very limited. Therefore, elucidating the origin of the immune responses elicited by CEO vaccination is relevant for development of safer control strategies. In this study the transcription levels of key host immune genes (IFN-γ, IFN-β, IL-1β, IL-6, IL-8, IL-18) and viral genes (ICP4, ICP27, UL46, UL49), as well as viral genome loads in trachea were quantified at 6 and 12 hours post-challenge of CEO vaccinated and non-vaccinated chickens. Immediately after challenge a significant increase in IFN-γ gene expression was followed by a significant reduction in viral replication. In contrast to the rapid induction of IFN-γ, expression of the pro-inflammatory cytokines (IL-1β, IL-6, IL-8) and type I IFN β was either slightly reduced or remained at basal levels. These suggest that the former cytokines may not play important roles during immediate early responses induced by ILTV challenge in either vaccinated or non-vaccinated chickens. Overall, these results suggest that the rapid expression of IFN-γ may induce pathways of antiviral responses necessary for blocking early virus replication. [ABSTRACT FROM PUBLISHER]

Background: Iatrogenic laryngotracheal stenosis (LTS) continues to be a known complication of indwelling endotracheal tubes (ETTs). It is well established that secondary scar formation caused by inflammation and mucosal injury are the main mechanisms by which stenosis occurs. Additionally, there are reports of bacterial colonization of ETTs and its potential association with tracheal scar formation. We describe 4 cases of patients with history of intubation and/or tracheostomy and presumed LTS that improved with the management of concurrent bacterial laryngotracheitis. Methods: A retrospective case series of 4 subjects initially diagnosed at a tertiary care center with posterior glottic or subglottic stenosis and positive bacterial laryngotracheal cultures was performed. Results: All 4 patients with presumed LTS had culture-proven bacterial growth isolated from the laryngotrachea and were treated with adjunct antibiotics. In the first 3 cases, complete resolution of upper airway obstruction was achieved. The fourth patient had notable improvement in her airway status without the need for additional surgical intervention. Conclusion: This case series suggests that bacterial growth within the airway may play a larger role in adult postintubation airway injury. Those patients presenting with concern for LTS and symptoms suspicious for an ongoing bacterial infection may benefit from adjunct antibiotic therapy. [ABSTRACT FROM AUTHOR]

Infectious laryngotracheitis virus (ILTV) causes respiratory disease in chickens. This alphaherpesvirus infects laryngeal tracheal epithelial cells and causes outbreaks culminating in decreases in egg production, respiratory distress in chickens and mortality. There are several different vaccines to combat symptoms of the virus, including chicken embryo origin, tissue culture origin and recombinant vaccines. All vaccines licensed for use in the U.S. are tested for efficacy and potency according to U.S. federal regulation using a vaccine challenge assay involving the use of an ILT challenge virus. This challenge virus is provided to biologics companies by the Center for Veterinary Biologics (CVB), United States Department of Agriculture (USDA). The current USDA challenge virus originated from a vaccine strain and has been subjected to multiple passages in eggs, and may not represent what is currently circulating in the field. The objective of this study was to evaluate and compare the pathogenicity of USDA's challenge virus strain to the pathogenicity of a recent ILT field isolate. Using the challenge virus and various dilutions of the field isolate, clinical signs, mortality and pathology were evaluated in chickens. Results indicate that the field isolate at a 1:20 dilution is comparable in pathogenicity to the USDA challenge virus at a 1:4 dilution, and that the ILTV field isolate is a viable candidate that could be used as a challenge virus when evaluating vaccine efficacy. [ABSTRACT FROM AUTHOR]

The article discusses the study that determined the protection efficacy of a Serotype 1 Marek's Disease (MD) virus-vectored bivalent vaccine against MD and Laryngotracheitis (LT), using bacterial artificial chromosome (BAC) and oncogene MEQ (BACMEQ) as a vector. Topics discussed include replication of BACMEQ-glycoprotein B (BACMEQ-gB) and BACMEQ-glycoprotein J (BACMEQ-gJ) bivalent vaccines in chickens, and BACMEQ-gB vaccine to protect against challenge with LT virus (LTV).

The article discusses a study which examined the safety and efficacy of a turkey herpesvirus vector laryngotracheitis vaccine (HVT/LT) for chickens. Results showed that the HVT/LT vaccine presents an advantage against the modified live (ML) LT vaccines as it did not affect hatchability and virulence after passages in chickens, a result that is said to be expected as it has been used extensively as a vaccine against Marek's disease (MD) since 1973. It also cites the sufficiency of one shot of HVT/LT vaccination at first day of age of chicks to provide protection against laryngotracheitis virus (LTV) challenge at seven weeks of age.

Bordetella bronchiseptica is a well-known animal pathogen sporadically found associated with human infections, especially in immunocompromised hosts. We report a fatal case of sepsis caused by Bordetella bronchiseptica in a girl with laryngotracheitis and AIDS. [ABSTRACT FROM AUTHOR]

The article discusses a research study on the efficiency of infectious laryngothracheitis virus (ILTV) vaccines and possible interference of Newcastle disease virus (NDV) and infectious bronchitis virus (IBV). Researchers evaluated the protection induced by chicken embryo (CEO) vaccines and tissue culture origin (TCO) vaccines when combined with B1 type strain of NDV or the Massachusetts (MASS) and Arkansas (ARK) serotypes. Results showed no interference in the protection induced by TCO vaccine when combined with NDV and IBV vaccines.

The article reports on the efforts to eliminate the vaccinal infectious laryngotracheitis (LT) from the broiler chicken industry in a region of California through the implementation of a cooperative industry program that emphasizes the use of an extended downtime program between flocks placed on each ranch of two broiler companies. In 2005, an outbreak of LT in broiler chickens in the state started. A description of LT downtime is presented. Turkey herpesvirus-LT recombinant vaccine was used to vaccinate in ovo the first flock placed on each ranch. LT was subsequently found in only two flocks on different ranches. Vaccination against LT was stopped since both companies have been free of LT.

Infections of the airway in children may present to the anesthetist as an emergency in several locations: the Emergency Department, the Operating Department or on Intensive Care. In all of these locations, relevant and up to date knowledge of presentations, diagnoses, potential complications and clinical management will help the anesthetist and the surgical team, not only with the performance of their interventions, but also in buying time before these are undertaken, avoiding complications and altering the eventual outcome for the child. Diseases such as epiglottitis and diphtheria may show diminished incidence but they have not gone away and their clinical features and essential management remain unchanged. Paradoxically, perhaps, some conditions such as Lemierre’s syndrome appear to be making a comeback. In these instances, clinicians need to be alert to these less common conditions, not only in regard to the disease itself but also to potentially serious complications. This article describes those infections of the airway that are most likely to present to the anesthetist, their attendant complications and recommendations for treatment. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Laryngotracheitis (croup) is a rare manifestation of COVID-19 in adults. A 52-year-old female presented to the emergency department (ED) with shortness of breath and inspiratory stridor. Physical examination of the head and neck revealed a congested posterior pharyngeal wall. Laryngeal endoscopy with a 70-degree rigid endoscope demonstrated an edematous, bilaterally moving vocal cords. Chest radiographs showed tapering of the upper trachea (the "steeple" sign), which is observed in parainfluenza-associated croup infections. The patient was admitted to the intensive care unit (ICU) for close observation for possible airway compromise and the need for intubation. Upon which, she tested positive for COVID-19 by polymerase chain reaction testing of nasopharyngeal samples. A regimen of ceftriaxone, nebulized racemic epinephrine, and dexamethasone was initiated. During the current COVID-19 pandemic, early diagnostic testing for SARS-Cov-2 are strongly recommended even when symptoms are not typical of COVID-19. • A 52-year-old woman presented to the ER with a two-day history of shortness of breath and inspiratory stridor. • The patient was admitted to the ICU for possible surgical airway. she tested positive for COVID-19 by polymerase chain reaction testing of nasopharyngeal samples. • A regimen of ceftriaxone, nebulized racemic epinephrine, and dexamethasone was initiated. • The patient's symptoms started to improve over the next few days. On day 4 of hospitalization, she moved to a level 1 bed, and a week later, she was discharged • Early diagnostic testing for SARS-Cov-2 are strongly recommended even when symptoms are not typical of COVID-19 [ABSTRACT FROM AUTHOR]

Laryngotracheitis caused by human parainfluenza virus (HPIV) and not complicated by bacterial superinfection rarely causes sudden unexpected death in infants and toddlers, especially in the absence of stridor and a barking cough. We therefore describe a 15-month-old white male who died suddenly and unexpectedly with clinical and pathological features of laryngotracheitis caused by cultureproven HPIV-1 infection. Given the presence of mucosal inflammation extending into the vocalis muscle of the larynx without associated significant narrowing of the laryngotracheal airway lumen, we propose his death was a result of a laryngospasm, perhaps mediated by immune responses. [ABSTRACT FROM AUTHOR]

Background: Bacterial tracheitis may cause life-threatening airway obstruction. Methods: Records of patients admitted to the pediatric wards of Mackay Memorial Hospital between 1994 and 2005 with a diagnosis of bacterial tracheitis made on bronchoscopic visualization of thick membranous tracheal secretions were retrospectively reviewed. Results: A total of 40 patients (aged 1 month–8 years, 29 [73%] under 3 years old) were included. Cough, fever, dyspnea, and hoarseness were the commonest symptoms. Fourteen patients (21%) required intubation. The most frequently isolated bacteriae were α-hemolytic streptococcus (in 11, 38%), pseudomonas (5, 17%), and Staphylococcus aureus (4, 14%). Intubation was more frequent in patients seen between 1994 and 1999 compared with those seen later (8/12 early vs 9/28 late). In the early period α-hemolytic streptococcus (55%) and pseudomonas (36%) were isolated. In the later period the most frequently isolated bacteria was α-hemolytic streptococcus (28%), followed by S. aureus (22%). No patients died, but those with pseudomonas infection had more severe complications, including tracheal stenosis. The average hospital stay in the early period was 26.2 ± 20.5 days versus 9.1 ± 4.8 days in the late period. The corresponding lengths of stay in the intensive care unit were 10.5 ± 11.5 days and 2.0 ± 2.2 days. Conclusions: Bacterial tracheitis requiring hospitalization of children appeared to be milder in the second half of the study period. Pseudomonas tracheitis tends to have a severe course. [ABSTRACT FROM AUTHOR]

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Objective --Toluene diisocyanate (TDI)-induced asthma is a common cause of occupational lung disease. In addition, a sore throat is one of the complaints of TDI-exposed workers. The aim of the present study was to determine whether TDI exposure induces laryngeal and/or tracheal lesions in experimental animals. Material and Methods --Guinea pigs underwent naris application of TDI three times, and their respiratory tracts were then examined using light and electron microscopy. Some animals simultaneously received vitamins C and E, which function as antioxidant agents. Results --When TDI-treated animals showed the clinical sign of labored breathing, many eosinophils had appeared in the lamina propria and mucosa of both the larynx and trachea, which finally infiltrated the tract lumen through the ruptured epithelium. Laryngo-tracheal inflammation was more severe than that observed in the lungs. However, supplementation with antioxidant vitamins in TDI-treated animals ameliorated the respiratory eosinophilia. Conclusion --Naris application of TDI induced laryngotracheitis, which was significantly suppressed by the antioxidant vitamins. This implies a preventive effect of the vitamins on this occupational disease. [ABSTRACT FROM AUTHOR]