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.
Chronic Infectious Laryngitis: The Role of Empirical Therapy and Biopsy: A Report of 5 Cases
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Abstrak
Laringitis berjangkit kronik adalah mimik klinikal kanser peti suara disebabkan oleh etiologi bakteria dan kulat. Kedua-dua penyakit mempunyai gejala tidak spesifik dan leukoplakia semasa pemeriksaan. Peranan biopsi tanpa risiko kanser peti suara boleh dipertikaikan kerana ia biasanya responsif terhadap terapi antikulat. Kajian ini bertujuan untuk mengkaji faktor predisposisi dan peranan biopsi dalam laringitis berjangkit kronik. Semakan retrospektif terhadap kes laringitis berjangkit kronik di pusat kami antara 2018 dan 2021 telah dijalankan. Ciri-ciri klinikal, faktor risiko, terapi antikulat dan keberkesaan telah dikaji. Lima kes laringitis berjangkit kronik dirawat dengan jayanya dengan terapi antikulat empirikal kecuali satu kes refraktori. Biopsi kes refraktori adalah negatif untuk kanser dan Staphylococcus aureus laryngitis budaya telah berjaya dirawat dengan antibiotik. Terapi antikulat empirikal dalam kes laringitis kulat berjangkit kronik dengan susulan berkala mempunyai hasil yang baik. Biopsi harus dilakukan untuk kes refraktori untuk mengecualikan kanser dan membimbing terapi antimikrob selanjutnya.
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