Fungal Laryngitis in Immunocompetent Patients; Risk Factors, Presentation and Treatment

Volume 1 - Issue 3

Ibrahim J Issa* and James P Thomas

Received: November 05, 2018;   Published: November 26, 2018

DOI: 10.32474/SJO.2018.01.000114

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Abstract

Introduction: Fungal laryngitis in immunocompetent patients is an underestimated disease that is not enough studied in the literature. In this study we are presenting the largest patients’ charts data analysis up to this date.

Results: Ninety three patients with fungal laryngitis are analyzed in this study. Ninety one of them were presumably immunocompetent. 69 patients (74.19%) were found to be using inhaled steroids, 15 patients (16.13) were using oral steroids, 8 patients (8.60%) were using nasal steroid sprays, 11 patients (11.83%) were on antibiotics, 13 patients (13.98) have reflux symptoms. Other risk factors like diabetes mellitus, history of intubation, vocal cord palsy, and smoking were also found and studied. Precise and detailed analysis was done for the presenting appearance of the lesions, most patients were found to present with a thin white plaque like lesions, many patients presented with varying types of lesions ranging from subtle whitish spots with surrounding inflammatory changes to as obvious as ulcer like elevated thick white lesions on the vocal cords.

Discussion: Low threshold for the diagnosis of fungal laryngitis is needed when appreciating one or more of the disease risk factors, detailed high definition video-stroposcopy is needed to diagnose and follow patients’ lesions and their progression with treatment. We have divided patients into six groups regarding their presenting lesions appearance, studying each presentation percentage and showing laryngoscopy examples makes it easy to diagnose patients, follow them up and assessing the change in lesion with treatment. Under estimation of the problem common occurrence, lack of awareness of the appearance of these lesions, over estimation of other laryngeal problems, and the inappropriate low definition rapid less detailed laryngoscopic examination are some presumed causes behind missing most of the patients with this diagnosis.

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