INFRAGLOTTIC AND BRONCHIAL INFECTIONS

The Yankees are rapidly finding out the benefits of the telephone. A newly made grandmamma, we are told, was recently awakened by the bell at midnight, and told by her inexperienced daughter, “Baby has the croup. What shall I do with it?” Grandmamma replied she would call the family doctor, and would be there in a minute. Grandmamma woke the doctor, and told him the terrible news. He in turn asked to be put in telephone communication with the anxious mamma. “Lift the child to the telephone, and let me hear it cough,” he commands. The child is lifted, and it coughs. “That's not the croup,” he declares, and declines to leave his house on such small matters. He advises grandmamma also to stay in bed; and, all anxiety quieted, the trio settle down happy for the night.(138) Concerns over infraglottic and bronchial infections have been a source of anxiety and lost sleep for many children, parents, and physicians long before the advent of the telephone. The annual incidence of lower respiratory tract infections in children younger than 6 years old exceeds 5 million in the United States.(83) Despite the frequency of these infections, the often common and nonspecific clinical symptomatology, variable severity, and changing epidemiology over time all have contributed to our understanding and misunderstanding of these disorders. The anxiety of the relatives described in the opening passage is a poignant reminder that the diagnosis of diphtheritic croup at that time carried a mortality of around 25%.(62) By simple definition, laryngitis, tracheitis, bronchitis, and any combination of terms (e.g., laryngotracheitis, laryngotracheobronchitis [LTB], tracheobronchitis) represent inflammatory conditions of part or parts of the airway.42, 155 In this basic form, no specific causes, infectious or noninfectious, are implied by these terms.