Laryngitis

Laryngitis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Inflammation of the mucosa of the larynx
  • The most common cause is viral upper respiratory infection
  • Also can be caused by phonotrauma (vocal abuse/misuse)
    • Coughing/throat clearing
    • Excessive speaking during a URI
    • Screaming or yelling
    • Excessive talking
    • Talking in noisy environments
    • Smoking
  • Peaks parallel epidemics of individual viruses
  • Most common during late fall, winter, early spring

Etiology

  • Viral upper respiratory infections most common in acute laryngitis:
    • Influenza A and B
    • Rhinovirus
    • Parainfluenza types 1 and 2
    • Adenovirus
    • Less common (or in immunocompromised):
      • Coxsackievirus, RSV, HSV, HIV, etc.
  • Bacterial infections:
    • β-Hemolytic streptococcus
    • Streptococcus pneumoniae
    • Haemophilus influenzae (HiB)
    • Moraxella catarrhalis
    • Staphylococcus aureus (including MRSA)
    • Less common: Pertussis, diphtheria, TB, syphilis, leprosy
  • Phonotrauma (Voice abuse or misuse)
  • Laryngopharyngeal reflux (LPR) from gastroesophageal reflux disease (GERD) (especially in adults)
  • Fungal infections (often associated with inhaled steroid use or immunocompromised)
  • Allergic
  • Inhalation or ingestion of caustic substances or other irritants
  • Autoimmune (rheumatoid arthritis, relapsing polychondritis, Wegener granulomatosis, or sarcoidosis)
  • Trauma
  • Idiopathic

Pediatric Considerations
  • Acute spasmodic laryngitis (spasmodic croup)
  • More likely to be infectious
    • Consider HiB, diphtheria, etc., if not immunized
  • Consider foreign body

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Basics

Description

  • Inflammation of the mucosa of the larynx
  • The most common cause is viral upper respiratory infection
  • Also can be caused by phonotrauma (vocal abuse/misuse)
    • Coughing/throat clearing
    • Excessive speaking during a URI
    • Screaming or yelling
    • Excessive talking
    • Talking in noisy environments
    • Smoking
  • Peaks parallel epidemics of individual viruses
  • Most common during late fall, winter, early spring

Etiology

  • Viral upper respiratory infections most common in acute laryngitis:
    • Influenza A and B
    • Rhinovirus
    • Parainfluenza types 1 and 2
    • Adenovirus
    • Less common (or in immunocompromised):
      • Coxsackievirus, RSV, HSV, HIV, etc.
  • Bacterial infections:
    • β-Hemolytic streptococcus
    • Streptococcus pneumoniae
    • Haemophilus influenzae (HiB)
    • Moraxella catarrhalis
    • Staphylococcus aureus (including MRSA)
    • Less common: Pertussis, diphtheria, TB, syphilis, leprosy
  • Phonotrauma (Voice abuse or misuse)
  • Laryngopharyngeal reflux (LPR) from gastroesophageal reflux disease (GERD) (especially in adults)
  • Fungal infections (often associated with inhaled steroid use or immunocompromised)
  • Allergic
  • Inhalation or ingestion of caustic substances or other irritants
  • Autoimmune (rheumatoid arthritis, relapsing polychondritis, Wegener granulomatosis, or sarcoidosis)
  • Trauma
  • Idiopathic

Pediatric Considerations
  • Acute spasmodic laryngitis (spasmodic croup)
  • More likely to be infectious
    • Consider HiB, diphtheria, etc., if not immunized
  • Consider foreign body

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