Candida laryngitis (1 of 4)
Severe laryngeal candidiasis, in a person using inhaled steroids at high dose. Standard light.

Candida laryngitis (2 of 4)
Closer view shows more clearly not only the white areas, but also surrounding inflammation. Standard light.

Candida laryngitis, 15 days after starting treatment (3 of 4)
After 15 days of oral fluconazole. Obvious improvement, but incomplete resolution of tissue changes.

Candida laryngitis, several months later (4 of 4)
After longer-term fluconazole, along with reduction of inhaled steroid dose, complete resolution. Strobe light, closed phase of vibration at high vocal pitch.

Candida laryngitis (1 of 4)
Candidiasis in patient using inhaled steroids for asthma. Under standard light, the lesions are vague, hazy, and best seen anteriorly on the right cord (left of image).

Candida laryngitis (2 of 4)
Same patient, narrow-band illumination. This not only emphasizes vascularity, but brings out the candida colonies.

Candida laryngitis, after treatment (3 of 4)
After treatment with fluconazole, the colonies have virtually disappeared.

Candida laryngitis, after treatment (4 of 4)
Same post-treatment examination, under narrow-band illumination. Note that there are normal specks of mucus (such as at the arrows) in the view.

Candida pharyngitis (2 of 2)
An even more dramatic case of candidiasis, in a different patient. Here, the colonies are more obvious and nearly confluent.

Candida pharyngitis (1 of 2)
Countless candida colonies in the hypopharynx (lower throat) of a patient who, for treatment of an auto-immune disorder, is not only inhaling steroids but also taking high-dose steroids orally. Each tiny white dot represents a colony of the fungus.

Candida laryngitis (1 of 3)
Elderly woman with a history of laryngeal amyloidosis requiring laser sculpting several years earlier. Now using high-dose inhaled steroids, antibiotics, and oral steroids for unrelated pulmonary problem. Marked increase of hoarseness, and whitish discoloration, especially of the left vocal cord (right of image).

Candida laryngitis (2 of 3)
Closer view of hazy white areas and irregular right cord margin (left of image), presumed to be candida overgrowth. Empiric treatment with fluconazole is justified, given history and findings.

Candida laryngitis, after starting treatment (3 of 3)
Two weeks after starting fluconazole; the white areas are completely resolved. The patient’s voice had improved markedly within three or four days of starting the treatment.