CAUSES
β’ Virus infections - influenza A, B, parainfl uenza, adenovirus, coronavirus, rhinovirus, HPV, CMV, HSV, RSV, Coxsackie
β’ Bacterial infections - beta-hemolytic streptococcus, Streptococcus pneumoniae, H. influenza, tuberculosis, leprosy, Moraxella catarrhalis
β’ Misuse or abuse of voice
β’ Inhaling irritating substances (eg, air pollution)
β’ Aspiration of caustic chemical
β’ Aging changes - muscle atrophy, loss of moisture in larynx, bowing of vocal cords
β’ Esophageal reflux
β’ Fungal infections: Histoplasmosis, blastomycosis and Candida
β’ Parasites
β’ Spirochetes (syphilis)
β’ Allergic
β’ Autoimmune
β’ Idiopathic
β’ Vocal cord nodules/polyps - singerβs nodes
β’ Injury or compression of recurrent laryngeal nerve
β’ Retropharyngeal abscess
β’ Tumor
β’ Trauma - e.g., endotracheal intubation
β’ Inhaled combined corticosteroid-bronchodilator use
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DIFFERENTIAL DIAGNOSIS
β’ Croup
β’ Measles
β’ Diphtheria
β’ Vocal nodules or polyps
β’ Laryngeal malignancy
β’ Thyroid malignancy
β’ Gastroesophageal refl ux
β’ Epiglottitis
LABORATORY WBC elevated in bacterial laryngitis
DIAGNOSTIC PROCEDURES
β’ Fiberoptic or indirect laryngoscopy - red, inflamed and occasionally hemorrhagic vocal cords, with rounded edges, and exudate (Reinkeβs edema)
β’ Consider otolaryngologic evaluation and biopsy - laryngitis of greater than 2 weeks in adults with history of smoking or alcohol abuse
β’ Consider 24 hour pH probe - chronic laryngitis in adults with gastroesophageal reflux
β’ Strobovideo laryngoscopy - for diagnosis of subtle lesions