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Management of laryngeal candidiasis: an evidence-based approach for the otolaryngologist

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Abstract

Purpose

The authors aim to review available reports regarding laryngeal candidiasis and describe the existing evidence on the demographics, clinical manifestations, diagnosis, therapeutic options, and outcomes of this infection.

Methods

A review of articles on laryngeal candidiasis was conducted using PubMed® database from its inception through July 2019.

Results

Patients were mainly females presenting with complaints of dysphonia and associated gastroesophageal reflux history or inhaled corticosteroids use; although local predisposing factors were common, most patients were immunocompetent. The main anatomical affected subsite was the glottis with the presence of leukoplastic lesions. The diagnostic approach remains controversial, since some authors recommend prompt lesion biopsy and others rely on empirical antifungal treatment that showed effective results regarding symptoms and lesions resolution.

Conclusion

Laryngeal Candida infection is thought to be a rare condition, with limited available literature. The correct diagnosis is difficult for the otolaryngologist and a high level of suspicion is required. The authors emphasize the need to include this condition into the differential diagnosis in patients with predisposing factors presenting with suspected lesions. In addition, the conservative diagnostic approach with antifungal treatment seems to provide effective outcomes, although comparative clinical studies between diagnostic options are lacking.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Rua Conceição Fernandes, s/n, 4434-502, Vila Nova de Gaia, Portugal

    Pedro Valente, Joana Ferreira, Isabel Pinto, Nuno Medeiros, Pedro Oliveira, Eugénia Castro & Artur Condé

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  1. Pedro Valente
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Correspondence to Pedro Valente.

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The authors declare that they have no competing interest.

Research involving human participants and/or animals

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This is a review on retrospective studies which were conducted on already available data for which formal consent was obtained. Therefore, institutional ethical approval is not required according to the law and the national ethical guidelines.

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Informed consent was not obtained from individual participants due the fact that this review included retrospective studies for which formal consent was obtained.

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Valente, P., Ferreira, J., Pinto, I. et al. Management of laryngeal candidiasis: an evidence-based approach for the otolaryngologist. Eur Arch Otorhinolaryngol 277, 1267–1272 (2020). https://doi.org/10.1007/s00405-020-05865-4

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