Bacterial Laryngitis (can be acute or chronic)

Bacterial laryngitis is an infection of the vocal cord mucosa by bacteria (not a virus or fungal organism). During this infection, mucus produced in the larynx is usually colored yellow, green, or brown. This can occur in any person as an acute, self-limited infection. It typically resolves on its own with supportive measures like hydration and relative voice rest.

If the patient’s laryngitis continues unabated more than 5 days or so, or if there is a critical need for voice (such as for an upcoming performance), antibiotics can be prescribed. Definitive resolution of chronic bacterial laryngitis is more difficult.

Chronic Bacterial Laryngitis

Chronic bacterial laryngitis is seen in persons who have undergone radiotherapy or who have an immune defect. The laryngitis can often be improved with antibiotics, and hydration, when dryness is part of the problem. It often recurs when antibiotics are discontinued. Sometimes chronic antibiotic administration is needed. Or, motivated patients may learn how to do laryngeal irrigations.

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Bacterial infection? (1 of 5)

This young man has an autoimmune disorder and is taking a immunomodulator drug. He has been chronically hoarse for months. Is this further auto-immunity or a chronic bacterial infection?

Yellow mucus (2 of 5)

Notice yellowish mucus in the subglottis and the intense erythema of the subglottis. Culture shows staph aureus.

Improvement (3 of 5)

After several weeks of dicloxacillin, voice is dramatically improved, as is the laryngeal appearance (compare with photo 1).

Improved voice (4 of 5)

During voicing, excellent vibratory blur, correlating with his much improved voice.

Infection returns (5 of 5)

Some months after discontinuing antibiotics, hoarseness has returned along with infected mucus.