Chronic Infectious Laryngitis: The Role of Empirical Therapy and Biopsy: A Report of 5 Cases

Abstract

Chronic infectious laryngitis is a clinical mimic of laryngeal carcinoma which can be due to bacterial or fungal aetiology. Both conditions present with non-specific symptoms with leucoplakia on examination. The role of biopsy of laryngeal lesions in the absence of risk factors of laryngeal carcinoma is debatable as it responds to antifungal therapy. This study aimed to review the predisposing factors and role of biopsy in chronic infectious laryngitis. A retrospective review of all cases of chronic infectious laryngitis presented to our centre between 2018 and 2021 were conducted. Clinical features, risk factors, antifungal therapy and its response were reviewed. All cases of chronic infectious laryngitis avoided the need of biopsy while had successful empirical antifungal therapy except for one refractory case. Biopsy of the refractory case was negative for malignancy and the culture-proven Staphylococcus aureus laryngitis was successfully treated with antibiotics. Empirical antifungal therapy in cases of chronic infectious fungal laryngitis with close serial follow-up had good outcome. Biopsy should be reserved for refractory cases to exclude malignancy and guide further antimicrobial therapy.