Combined therapy for at least two weeks recommended for fungal laryngitis

September 27 2018

Fungal laryngitis is rare, but can be fatal if there is obstruction of the airways or it the infection becomes invasive (generally seen in immunosuppressed patients).

Dr NL Kunel’skaya and colleagues at Moscow Health Department (Russia) recently described a study of 430 patients suffering from chronic laryngitis. Of 100 patients (23%) who tested positive for fungal infection by direct microscopy and culture, the vast majority were caused by Candida (98%) and a small fraction by Aspergillus (2%). Three distinct forms were seen: hyperplastic (55%), catarrhal (31%) and atrophic (14%).

The patients with Candida laryngitis were divided into three treatment groups: topical only (A), systemic only (B), and both topical and systemic (C). They found that treatment with combined therapy (local clotrimazole/miramistin, plus systemic itraconazole/fluconazole) for at least two weeks was best, being successful in almost 80% of cases. They also recommend weekly examinations during treatment, plus follow-up at 3-monthly intervals after treatment has finished.

• Read the article: Kunel’skaya et al (2018) The treatment of laryngomycosis. Vestn Otorinolaringol 83(3):37-40
• Read more about Aspergillus laryngitis, and fungal laryngitis in immunocompetent patients, or the IDSA guidelines for treating laryngeal candidiasis with IV amphotericin B or IV/oral fluconazole

 

Laryngitis caused by Candida (left, Ravikumar et al. 2014) and Aspergillus (right, Khaund et al. 2014)