Infectious Laryngitis
Department of Otolaryngology, Head and Neck Surgery

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5. Bacterial Laryngitis

Patient History: This is a 20 year old female who has had hoarseness for a month and a half after an upper respiratory infection. She has had a lot of coughing and has been unable to sing in class for the last month.

Physical Findings: Purulent secretions can be seen in the entire larynx and also in the trachea. These secretions frequently get caught on the cords and the patient has frequent throat clearing. Notice the secretions on both vocal cords.

Comments: Bacterial laryngitis occurs frequently with bronchitis and is predominantly caused by M.catarrhalis and H.influenzae.

6. Fungal Laryngitis

Patient History: This is a 45 year old gentleman who has been hoarse for several months. He has no shortness of breath but does have a productive cough. He has a history of extensive drinking and drug addiction.

Physical Findings: On this photograph the fungal elements are visible in the entire supraglottic larynx over the entire arytenoid area and posteriorly also on the pharynx. The fungal elements can also be seen on the vocal cords. There are large patches of thick white material in the supraglottic laynx.

Patient History: This is a 35 year old gentleman who has had a history of hoarseness and several months of a cough. He has been on several courses of antibiotics and has been treated with Zithromax, Clindamycin, Augmentin and now is complaining of throat pain. He also had bronchodilators and inhaled steroids for his asthma.

Physical Findings: Fungal infection can be seen on the vocal cords, false cords, and the mucosa of the supraglottic larynx (above the vocal cords). These are thickened white patches that involve the entire area. Sometimes they are less extensive as in the last figure below which shows fungus on the true cords only, sometimes seen in patients with inhales steroids.

Comments: Fungal laryngitis is most commonly caused by candid albicans and occurs in immuno-compromised patients. The patients on long courses of antibiotics or patients receiving inhaled steroids are also susceptible to this type of laryngitis. Treatment includes systemic antifungals.

7. Viral Laryngitis

Patient History: This is a 66 year old female who recently was hospitalized for pneumonia and an upper respiratory infection. Since that time she has had hoarseness. For several days she was having a sore throat, difficulty with pain on swallowing but no shortness of breath.

Physical Findings: Viral infections cause erythema of the entire larynx. The vocal cords, the false cords and the surrounding tissues there is hypervascularity and edema.

Comments: Viral laryngitis is the most common cause of hoarseness and it occurs very frequently with upper respiratory infections. This is usually an acute laryngitis that lasts a few days up to one week. It is treated with supportive care.

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