Herpes Simplex Virus laryngitis may present with stridor in kids, finds study

Herpes simplex virus (HSV) infection of the larynx is an exceedingly rare clinical entity. It has been reported in a pediatric population who present with acute upper respiratory obstruction requiring intensive care and ventilatory support. Due to the rarity of HSV laryngitis, the symptoms and clinical course are not well understood. Therefore, researchers of Boston conducted a study to completely characterize HSV laryngitis in order to aid clinicians in understanding and recognition of HSV laryngitis.

Researchers conducted a Systematic Reviews to identify articles relating to HSV laryngitis from MEDLINE, EMBASE, and Cochrane Database. They extracted patient demographics, presenting signs and symptoms, treatment and clinical course from the selected manuscripts. They included 31 studies on HSV laryngitis that identified 36 patients (17 pediatric, 19 adults).

Key findings of the study were:

• Among the pediatric population, they noted that stridor was more common at presentation when compared with the adult population.

• They also noted that adults were more commonly presented with dysphagia and dysphonia.

• They found that adult patients were more likely to undergo tracheotomy than pediatric patients.

• The mean length of hospital stay was 21 days for children and 16 for adults respectively.

The authors concluded, "HSV laryngitis has a unique presentation in pediatrics and adults, but is nonspecific in both populations leading to delays in diagnosis and treatment. HSV laryngitis is associated with significant morbidity including multi-week hospital stay and risk for needing tracheostomy in both adults and pediatric population which demonstrates the need for clinical awareness of this complication of HSV infection".

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DOI: https://doi.org/10.1016/j.ijporl.2020.110596