incidence of the named complications in these infections was no higher than that found in series without steroid treatment. Accordingly, there is no reason to ascribe these complications to the steroid therapy. Metastasization of mycotic infection was found in 3 patients, 2 with pneumonia and one with sepsis, and it must be assumed that the steroid therapy may have been a contributory cause of this complication. In one of the cases the complication caused severe cerebral defects, but this patient could hardly have survived the infection without steroid therapy.The conclusion from this analysis is not particularly optimistic in respect to the therapeatic value of steroid therapy in serious infections. It must be taken into consideration, however, that we were very critical in selecting cases in which a definite steroid effect seemed to be demonstrable, and in fact a beneficial effect upon the infectious shock had been recorded in 7 of the 70 patients, although in 6 of them it was regrettably not of any significance to the subsequent course.During the past 3% years a brief course of steroid therapy has been used in a number of the most severe cases of laryngitis stridulosa treated at the Paediatric Department of Sundby Hospital, Copenhagen.In order to assess the result of this treatment, all cases of laryngitis admitted during the past 5 years were analysed. This series totals 265 children (180 boys and 85 girls). Thirty-four of these cases were rather serious, involving cyanosis and/or a debilitated general condition. Out of these 34 patients 26 had been admitted during the past 3% years, and 15 of them received steroid therapy. During the same period 2 had tracheotomy (and were not treated with steroids). During the preceding 18 months there had been 8 severe cases, 4 of whom had tracheotomy.The steroid therapy gave a more rapid subsidence of the symptoms, and the patients were sooner tided over the life-threatening condition compared with the severe cases treated with other medication. Moreover, they fared on the whole better than the tracheotomized patients who were often greatly troubled by accumulation of secretion in the airways.The steroid medication was not accompanied by any side effects, in particular not by a flare-up of the infection.We recommend this treatment in the more serious cases of laryngitis stridulosa. Owing to the rapid onset of their effect, hydrocortisone preparations are best suited.
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