Symptoms
In spasmodic laryngitis or croup there is a slight catarrhal inflammation of the mucous membrane lining the larynx and a marked spasm of the larynx. There may be a slight discharge from the nose and slight hoarseness. The attacks usually come on at night with a hollow, metallic cough. About this time there is difficult breathing and the cough becomes more severe and of a teasing nature, the child making every possible effort to keep from coughing. The voice becomes husky but is seldom lost. There is rapid pulse and a slight temperature seldom over 101° F. The attack lasts three or four hours, after which the child will fall asleep. The dyspnea is aggravated and the spasm increased by excitement. During the day the child will appear well except for the slight cough and hoarseness, but the second night the attack will return with about the same degree of severity as that of the first night. Usually the attack may not return the third night or if it does it will be less severe.
Spasmodic laryngitis should not be confused with laryngismus stridulus, membraneous croup or with acute catarrhal laryngitis. According to Holt and Howland laryngismus stridulus occurs only in infants, and there is not only stridulous breathing, but also periods of complete arrest of respiration.