Laryngitis: Causes, Symptoms, Treatment & When to See a Doctor

Laryngitis = inflammation of the laryngeal mucosa/vocal folds causing hoarseness or aphonia.

Etiology

• Viral (most common): Rhinovirus, influenza, parainfluenza, RSV.
• Bacterial: Group A Strep, Moraxella, Haemophilus (rare primary).
• Non‑infectious: Vocal overuse, GERD/LPR, allergies, irritants (smoke, chemicals), intubation trauma.

Symptoms

• Hoarseness, roughness, breathiness, vocal fatigue.
• Sore throat, dry cough, throat clearing.
• Fever, malaise (if infectious).
• Dysphagia, odynophagia (less common).

Management

1. Voice rest: Relative (avoid whispering – increases strain); complete if aphonic.
2. Hydration: 2–3 L water/day; humidified air.
3. Avoid irritants: Smoke, alcohol, caffeine, spicy foods.
4. Symptomatic: Lozenges (menthol/honey), acetaminophen/ibuprofen for pain.
5. GERD treatment: PPI + lifestyle if LPR suspected.

Antibiotics?

Only if bacterial superinfection suspected (persistent >10 days, purulent sputum, fever). Most are viral – antibiotics ineffective.

Red Flags – ENT Referral

• Hoarseness >3 weeks (rule out neoplasm, vocal fold paralysis).
• Stridor, dyspnea, drooling (airway compromise).
• Hemoptysis.
• Neck mass.
• Immunocompromised host.