clinical features

Last reviewed 01/2018

Symptoms are usually self limiting and patients recover within two weeks (1)

Mucous stasis may cause episodic coughing and throat clearing behaviours.

Patients often complain of dysphonia and/or dysphagia.

• dysphonia may present as breathiness, harshness, limited pitch range, and reduced vocal projection or loudness
• dysphagia may manifest as globus (foreign body) and choking sensations, pain during swallowing, regurgitation episodes, and the feeling of food getting stuck in the throat or upper esophageal region

Fever and systemic symptoms may be seen in both bacterial and viral infections

• presence of the following often indicates bacterial origin

• production of pseudomembrane or serous casts, purulence, marked erythema, and co-involved distant sites (for example, lung, tonsils)
• grey membranous cast pathognomonic for diphtheria is rarely seen nowadays

• viral illness may be suggested in

• blisters, especially in herpes zoster and associated nerve paresis of the lower cranial nerves
• erythema and pain disproportionate to the mucosal appearances

Patients with supraglottitis and epiglottitis associated with H. influenza presents with rapidly progressing odynophagia, dysphagia, hoarseness, drooling, and stridor. These patients are at high risk of impending airway compromise and require emergency assessment and airway management (2).

Reference:

• (1) Dworkin-Valenti JP et al. Laryngeal Inflammation. Ann Otolaryngol Rhinol 2015;2(9): 1058
• (2) Wood JM, Athanasiadis T, Allen J. Laryngitis. BMJ. 2014;349:g5827
• (3) Cochrane Briefs. Antibiotics for Acute Laryngitis in Adults. American Family Physician July 2005; 72(1)