Fungal Laryngitis in Immunocompetent Patients; Risk Factors, Presentation and Treatment by Ibrahim J Issa in
SJO -
Lupinepublishers
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.
