Laryngitis
Girish D. Sharma, MD, FCCP
Introduction/Etiology/Epidemiology
•Laryngitis is an inflammation of the larynx and vocal folds from a variety of causes, including infection, irritants, and vocal strain (overuse) (Box 46-1).
Box 46-1. Causes of Laryngitis
Viral
Common: Rhinovirus, influenza, parainfluenza, adenovirus, respiratory syncytial virus
Less common: Measles, mumps, varicella zoster, human immunodeficiency virus, coxsackievirus
Bacterial
Haemophilus influenzae type b, Streptococcus pneumoniae, Staphylococcus aureus, β-hemolytic streptococci, Moraxella catarrhalis, Klebsiella pneumoniae
Rarely diphtheria (in unimmunized subjects), mycobacteria
Fungal
Laryngeal candidiasis (thrush), Aspergillus
Systemic disorders
Rheumatoid arthritis, Wegener granulomatosis, sarcoidosis
Vocal trauma and strain
Prolonged yelling, screaming, forceful singing or speaking, persistent coughing, habitual throat clearing, and prolonged use of abnormal loudness or pitch in speech
Miscellaneous and environmental
Laryngopharyngeal reflux associated with gastroesophageal reflux and prolonged exposure to irritants, allergens, pollutants, toxins, dust, and smoke
Trauma, surgery and/or intubation, corrosive ingestion
• Acute laryngitis is usually infectious in origin, most commonly viral.
•Inflammation and edema of the larynx impair vibration of the vocal folds, resulting in symptoms suggestive of laryngitis.
•Symptoms that last for >3 weeks are suggestive of chronic laryngitis.
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