Chronic bacterial laryngitis
This 73-year-old male had intermittent hoarseness in the past. 6 weeks prior to his visit he developed hoarseness that did not go away. On his exam, he had a red, dry, crusty irritation.
I treated him with fluconazole for 2 weeks and he did not improve. He was also taking azithromycin for a skin infection from another physician. He remained hoarse and his vocal cords still looked dry and crusty.
I then placed him on 10 days of tetracycline. He reported that he was partially improved and I continued the medication for a total of 20 days. His hoarseness resolved and his vocal cords returned to a normal, healthy appearance.
His symptoms returned approximately 6 months later.
I treated him with Septra DS for a presumed recurrent acute bacterial laryngitis. He improved fairly quickly on a 14 day treatment.
I based the treatment upon a recent article by Adam Klein - Methicillin-Resistant and Methicillin-Sensitive Staphylococcus
The following year he developed hoarseness for a period of nine days but it resolved spontaneously before he had an appointment. His voice remains normal over one year since his last treatment.