Fungal laryngitis in immunocompetent patients

Abstract

Introduction: The fungal laryngitis is an unusual disease in immunocompetent pa- tients, however should take into consideration in the differential diagnosis of leukopla- kias, especially in patients with predisposing factors such as pharyngolaryngeal reflux, use of inhaled, oral or intravenous corticosteroids. Aim: Describe a series of cases of fungal laryngitis in immunocompetent patients with clinical diagnosis and empirical antifungal treatment. In addition, finding the asso- ciation with predisposing factors keys. Material and method: Retrospective study of 11 patients with diagnosis of fungal laryn- gitis according to clinical presentation, predisposing factors and findings in the laryngeal videostroboscopy (vocal folds leukoplakias) joined the response to empirical treatment with oral fluconazole. Also an extensive literature review was conducted until 2015. Results: The main predisposing factor was the pharyngolaryngeal reflux (91%) fo- llowed by use of corticosteroids (55%). All patients were treated empirically with fluconazole for 14-21 days. 100% of patients responded successfully, with remission of symptoms and laryn- geal lesions. Conclusion: Clinical diagnosis and treatment with fluconazole as first-line treatment generate good response rate, provided that the patient’s symptoms and signs with the findings in the larynx are correlated.