Fungal laryngitis should be suspected in refractory cases.This is seen in immuno compromised as well as immuno competent cases.It mimics leucoplakia, or malignancy.

1. Fungal Laryngitis
Dr Shrikant Phatak
Head of ENT Department
Choithram Hospital & Research Center
Indore

2. Fungal Laryngitis
Fungal laryngitis is a rare diagnosis but should
be kept in mind in cases of refractory laryngitis.
• Can be seen both in immuno compromised
and immuno competent individuals.

3. Fungal Laryngitis
• The presence of fungal infection of the larynx
can mimic
• Gastro oesophageal reflux disease,
• Granulomatous diseases,
• Leucoplakia
• Carcinoma

4. Fungal Laryngitis :Clinical features
• The usual mode of presentation is
• Change of voice,
• Dysphagia,
• Odynophagia
• Rarely dyspnoea.

5. Fungal Laryngitis Predisposing factors
• Diabetes mellitus ,
• Smoking
• Long term use of inhaled ,oral ,nasal steroids
• history of acid reflux symptoms
• History of intubation

6. Fungal Laryngitis
• Diagnosis of fungal laryngitis is
on clinical suspicion in patients
with the onset of the
symptoms and its close
relation with the presence of
risk factors.
• Vocal cords that show whitish
discoloration with normal
mucosal waves
• Rapid and obvious
improvement on antifungal
treatment clearly seen on
subsequent follow up
Stroboscopy.

7. Stroboscopic Appearance
True vocal cords were the most affected laryngeal site Most of the patients
present with a white thin “faint” plaque like lesion

8. Fungal Laryngitis
• The most common fungus causing laryngitis is
Candida
• Other fungal infections like Aspergillosis,
Blastomycosis, Histoplasmosis can also be seen

9. Stroboscopic Appearance
Pre treatment Post treatment
White thick discharge that is not coughed up or cleared,

10. Stroboscopic Appearance
Whitish spots with surrounding inflammatory changes

11. Stroboscopic Appearance
Pretreatment Post treatment 3 weeks
Ulcer like elevated thick white lesions on the vocal cords
in a chronic smoker & alcoholic

12. Treatment
Laryngeal Candida responds extremely well to
treatment.
Biopsy is usually not needed
• Oral Fluconazole/ Itraconazol 200mg for the
first day and then 100mg till complete
resolution of the infection.
• Usually requires 4 to8 weeks course
depending on the extent of involvement

13. Fungal Laryngitis
• Thank you

14. Disclaimer
• The information contained in the presentation is based on the personal
experience and cases collected at Choithram Hospital Indore over the last
20 years.
• It is intended for the use of Medical students ENT post graduates.
• The views expressed are purely on personal opinion. viewers can make
their own opinion. For any confusion please contact sole author.
• Everybody is allowed to copy or download the material best suited to him.
I am not responsible for any controversies arising out of the presentation.
• For any suggestions or corrections you may please contact
phatak_shrikant@yahoo.in