ENT
Laryngitis
Inflammation of the voice box causing hoarseness. Usually viral.
- ICD-10
- —
- Source
- OPD handbook pp.12–13, 16
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
- Hoarseness of voice
- Dry, irritating cough
- Fever
- Body aches
Red flags Refer urgently if any are present
- Loss of weight
- Male smoker
- Fever and cough for months: think of cancer of the lung or larynx
Diagnosis
- Cause: usually viral
- Triggers: singing in a loud pitch, shouting or weeping
- Differential diagnosis: vocal cord nodule (teachers, singers; history of months)
Treatment
Step 1 of 5
1. Steroids (3–5 days)
- Dexamethasone or prednisolone for 3–5 days
Prescription
PrednisoloneCorticosteroid
Dose1 mg/kg
Brand Rapicort 5 mg / Deltacortril 5 mg
3–5 days
Also sold as Deltacortril, Rapicort, Rapicort EC, Prednisolone 5 mg
Step 2 of 5
2. NSAIDs
Prescription
Step 3 of 5
3. Cough suppressant
- Ivy leaf is the best according to the book
Prescription
Ivy leaf extract (cough syrup)Herbal cough suppressant / expectorant
Dose2 TSF TDS (tablet: 1 TDS)
Brand Syp Samvy / Prospan / Hylixid, or Tab Coferb Plus
Also sold as Prospan, Samvy, Hylixid, Coferb Plus, Hylixia
Step 4 of 5
4. PPI
- Reason: to avoid steroid-induced gastritis
Prescription
OmeprazoleProton pump inhibitor
Dose20 mg BD (1+1), as in the sample prescription
Brand Risek / Teph / Ruling
Also sold as Risek, Teph, Ruling, Ruling sachet, Omega
Step 5 of 5
5. Antibiotic (only if indicated)
- Indication: high-grade fever, or greenish / yellow sputum
Prescription
AzithromycinMacrolide antibiotic
Dose500 mg OD
Brand Tab Azitma / Arzomic
Also sold as Zithromax, Azomax, Azitma, Arzomic, Zyto, Genthro
Caution: QT prolongation; caution with other QT-prolonging drugs
Sample prescription from the book (patient details removed)
- Adult, 60 kg, fever and hoarseness for 2 days with body aches; pharynx clear, tonsils not enlarged: Tab Azitma 500 mg 1+0; Tab Rapicort EC 5 mg 4+4 for 3 days; Tab Nims 100 mg 1+1; Cap Ruling 20 mg 1+1; Syp Samvy (ivy leaf) 2+2+2 spoons; advised to speak in a soft voice.