Laryngitis Treatment For Both Adults And Pediatrics in OPD

A patient presents with hoarseness of voice, dry, irritating cough, fever, body ache.

Cause:

• Triggering factors: Singing in a loud pitch, weeping.

Differential Diagnosis:

• Vocal cord nodule (common in teachers, singers)
• History of months of hoarseness

Alarming Signs:

• Loss of weight → Suspect malignancy
• Smoker → Risk of lung cancer
• Fever with cough for months → Suspect laryngeal carcinoma

Management For Adults

Category	Medication	Generic Name	Dosage	Safe in Pregnancy
Steroids	Tab. Rapi-Cort	Prednisolone	5 mg BD	Use with caution
	Tab. Deltacortil	Prednisolone	5 mg BD	Use with caution
	Dexamethasone	Prednisolone	0.5 mg – 1 mg BD	Avoid prolonged use
NSAIDs	Tab. Panadol	Paracetamol	500 mg TDS	Safe
	Tab. Ibuprofen	Brufen	400 mg TDS	Contraindicated in 3rd trimester
Cough Suppressants	Syp. SAMY	Ivy Leaf Extract	1–2 TSF TDS	Safe
	Syp. Prospan	Ivy Leaf Extract	2 TSF TDS	Safe
	syp Hylixia	Ivy Extract	2 TSF TDS	Safe
	Syp. Benylin	Dextromethorphan Hydrobromide	2 TSF TDS	No
	Tab. Corex Plus	Chlorpheniramine Maleate + Codeine Phosphate	1 Tab. TDS	No
PPI (For Gastritis Prevention)	Tab. Risek	Omeprazole	20 mg OD (Before breakfast)	Safe

Antibiotics (For Laryngitis)

Antibiotics are only indicated in cases of:

• High-grade fever
• Purulent sputum production

Recommended Antibiotic:

• Azithromycin (Azomax/Zyro/Azitma) 500 mg OD

Bacterial vs. Viral Infections (Diagnostic Approach)

1. The patient has hoarseness of voice, body aches, and fever.
2. Temperature and throat examination indicate that laryngitis is mostly viral.
   • If the fever is above 101°F, it is more likely bacterial.
3. In bacterial laryngitis, antibiotics are necessary, while in viral laryngitis, antibiotics are not required.
4. To differentiate between viral and bacterial infections, refer to CBC (Complete Blood Count).

• CBC Findings:
  • ↑ Lymphocytes → Viral infection
  • ↑ Neutrophils → Bacterial infection