Utilisateur:Michaël St-Gelais/Brouillons/Laryngite virale aiguë

Laryngite virale aiguë

Maladie
Laryngite aiguë secondaire à un RGO
Caractéristiques
Signes	Signe clinique, Signe clinique 1, Signe clinique 2
Symptômes	Rhinorrhée, Stridor, Dyspnée , Détresse respiratoire, Contacts infectieux, Voix rauque, Traumatisme laryngotrachéal, Toux , Surutilisation de la voix, Statut vaccinal, ... Reflux gastro-œsophagien, Inconfort laryngée, Température corporelle élevée  [+]
Diagnostic différentiel	Polypes, Corps étrangers, Troubles neurologiques, Laryngite Chronique, Nodules, Cancer des voix respiratoire supérieur
Informations
Terme anglais	Acute laryngitis
Spécialité	ORL
Page non révisée

__NOVEDELETE__

La laryngite est une inflammation des muqueuses des cordes vocales et du larynx. La laryngite virale aiguë est, comme son nom le suggère, d'origine virale, généralement bénigne, auto-limitative et dure de 3 à 7 jours. Elle est dite aiguë si elle dure moins de trois semaines.

Épidémiologie

L'épidémiologie est difficile à déterminer car, étant une affection auto-limitante lorsqu'elle est d'origine virale, plusieurs patients ne sollicitent pas de soins médicaux.

Toutefois, certaines études estiment qu'environ 2% des personnes présentant des symptômes respiratoires aigus ont une laryngite aiguë.

La laryngite aiguë est plus fréquente chez les adultes par rapport aux enfants. Le ratio homme/femme varie selon les études.

Les personnes atteintes ont un âge situé entre 18 et 40 ans.

Étiologies

La laryngite virale aiguë survient généralement dans le contexte d'une infection des voies respiratoires supérieures (IVRS) causée par un des pathogènes suivants :

• le virus para-influenza (responsable de 1/2-3/4 des cas)
• le virus respiratoire syncytial;
• l'adenovirus;

• le rhinovirus;
• le coronavirus.

Laryngitis is an inflammation of the larynx, which can cause hoarseness or loss of voice. Here are some possible causes of laryngitis in adults based on the search results :

• Viral infections: Most cases of laryngitis are caused by viral infections, such as the common cold or flu.
• Bacterial infections: Although less common, bacterial infections can also cause laryngitis.
• Irritants: Exposure to irritants such as smoke, pollution, or chemicals can cause laryngitis.
• Acid reflux: Acid reflux can irritate the larynx and cause inflammation.
• Overuse or misuse of the voice: Speaking or singing loudly, shouting, or talking for extended periods of time can strain the vocal cords and cause laryngitis.
• Allergies: Allergies can cause postnasal drip, which can irritate the larynx and cause inflammation.
• Dry air: Breathing dry air can dry out the vocal cords and cause laryngitis.

It's important to note that these causes may not be exclusive to adults and may also apply to children.

Physiopathologie

Dans la laryngite aiguë de l'adulte, l’inflammation concerne particulièrement la muqueuse des plans glottique et épiglottique, tandis que chez l'enfant, il y a préférentielle atteinte de la muqueuse sous-glottique. La localisation de ces atteintes se manifestera principalement chez l'adulte par de la dysphonie, tandis que la dyspnée sera la principale plainte chez l'enfant.

La processus inflammatoire se déroule en plusieurs phases.

• Tout d'abord, il y a une congestion du larynx consécutif à l’inflammation. Elle peut concerner la partie supraglottique, glottique ou épiglottique. Cet œdème va affecter les vibrations des cordes vocales pouvant rendre difficile, voire impossible, la phonation. À ce stade, la muqueuse est œdématiée et érythémateuse.
• Il s'en suit une phase de guérison qui fait intervenir les globules blancs lorsque la cause est infectieuse afin d'éliminer les germes impliqués.
• Environ 2 semaines après le début du processus inflammatoire, la laryngite aiguë se résout. Une persistance des symptômes est souvent évocatrice d'une surinfection bactérienne ou alors d'une transition vers une laryngite chronique.

When the larynx is inflamed, the vocal cords may become swollen, which can affect the voice. In some cases, the inflammation may also cause pain or discomfort in the throat. Treatment for laryngitis may depend on the underlying cause and may include rest, hydration, voice therapy, medications, or surgery in rare cases.

Présentation clinique

Facteurs de risque

Les facteurs de risque sont :

• le facteur de risque 1 - Ceci est une balise sémantique de type facteur de risque que vous devez modifier.
• le facteur de risque 2 - Ceci est une balise sémantique de type facteur de risque que vous devez aussi modifier.
• le facteur de risque 3 - Copiez ce modèle pour définir d'autres facteurs de risques.
• ...

The risk factors for developing laryngitis include

:

• Having a respiratory infection, such as a cold, bronchitis or sinusitis
• Exposure to irritating substances, such as cigarette smoke, excessive alcohol intake, stomach acid, workplace chemicals, and dust that cause irritation
• Overusing your voice, by speaking too much, speaking too loudly, shouting or singing
• Consuming tobacco or cigarette smoke, and consuming alcohol
• Inhaled medications
• Poor vocal hygiene, which can lead to laryngitis or inflammation of the vocal folds. This is related to voice abuse, misuse, dehydration or indirect voice box inflammation secondary to sinus or mouth issues
• Smoking or vaping
• Autoimmune disorders such as granulomatosis with polyangiitis (Wegener’s disease) or pemphigoid/pemphigus
• Chronic sinusitis
• Infections with certain parasites
• Chronic use of steroid inhaler medications
• Working in an environment with irritating chemicals or dust
• Working, or having a hobby, that requires prolonged or very loud talking, shouting, or singing
• Voice abuse or misuse, which means talking too much or too loudly. It can be an ongoing problem for people whose jobs depend on their voices, including singers, actors, telephone operators, lawyers, teachers, referees, coaches, and anyone who must shout over loud noise at work (construction workers, personnel in airports and train stations, factory workers)
• Chronic sinusitis
• Asthma
• Tuberculosis (rare)
• Children can develop chronic laryngitis from voice overuse or misuse, especially if they shout or strain their voices during choir practice.

Questionnaire

Les symptômes de cette maladie sont :

• une toux dite aboyante
• la rhinorrhée
• la fièvre
• la voix rauque
• l'inconfort laryngée
• la dyspnée, la détresse respiratoire et le stridor (chez l'enfant).

Chez l'adulte, l'histoire est habituellement assez banale avec une histoire de voix rauque et des symptômes compatibles avec une IVRS. Chez l'enfant, la toux aboyante et le stridor sont nettement plus fréquents : une dégradation rapide des symptômes est généralement notée.

Il peut être pertinent de rechercher certains éléments d'histoire :

• une notion de traumatisme laryngotrachéal
• la surutilisation de la voix
• des antécédents de RGO
• le statut vaccinal
• les contacts infectieux.

The symptoms of laryngitis can vary depending on the severity of the inflammation and the underlying cause. The common symptoms of laryngitis include

:

• Hoarseness
• Difficulty speaking
• Sore, dry, or tickly throat
• Mild fever
• Irritating cough
• A constant need to clear your throat
• Weak voice or voice loss
• Tickling sensation and rawness in your throat
• Dry throat
• Persistent cough
• Frequent throat clearing

These symptoms usually begin suddenly and often get worse over a period of two to three days. The hoarse voice and speaking difficulties usually get worse each day you're ill and may last for up to a week after the other symptoms have gone. In a few cases, the larynx can swell and cause breathing difficulties. This isn't common in adults but can occur in young children who have smaller, narrower windpipes. Laryngitis is often linked to another illness, such as a cold, flu, throat infection (pharyngitis) or tonsillitis, so you might also have other symptoms such as headache, swollen glands, runny nose, and pain when swallowing. If your laryngitis symptoms last longer than two weeks, you should schedule an appointment with your healthcare provider.

Examen clinique

L'examen clinique permet d'objectiver les signes suivants :

• à l'examen clinique 1:
  • le signe clinique 1
  • le signe clinique 2
• l'examen clinique 2:
  • le signe clinique 3
• à l'examen clinique 2:
  • le signe clinique 1
  • le signe clinique 2
• ...

Quant à l'examen physique, elle peut se faire par examen direct de la gorge (laryngoscopie ou à l'aide d'un nasolaryngoscope flexible Les lésions retrouvées dépendent de la forme clinique

The physical exam for laryngitis is usually done by a doctor and may include

:

• Inspection of the throat and larynx using a lighted instrument called a laryngoscope
• Checking for swollen and inflamed vocal cords
• Listening to the voice of the person to assess the degree of hoarseness
• Checking for swollen lymph nodes or glands in the neck
• Assessing the ears, nose, and throat
• Taking a detailed medical history to determine the underlying cause of laryngitis

In most cases, laryngitis can be diagnosed by a doctor through a clinical examination. Most cases do not require any additional testing. However, if the doctor suspects that the underlying cause of laryngitis is a bacterial infection, they may order a throat culture to confirm the diagnosis. If the laryngitis lasts for more than two weeks or is chronic, the doctor may refer the person to an ear, nose, and throat (ENT) specialist for further evaluation and treatment.

Diagnostic différentiel

Le diagnostic différentiel est à faire avec d'autres pathologies pouvant entrainer un syndrome dysphonique ou dyspnéique, notamment:

• laryngite Chronique

• Corps étrangers
• troubles neurologiques tel dysphonie spasmodique
• D'autres lésions bénignes des cordes vocales telle que: polypes, nodules...
• Cancer des voix respiratoire supérieur

The differential diagnosis for laryngitis includes

:

• Upper respiratory tract infection
• Vocal fold cyst, nodule, or polyp
• Laryngeal stenosis
• Infectious or allergic chronic laryngitis
• Reflux laryngitis
• Rhinitis
• Spasmodic dysphonia
• Psychogenic dysphonia
• Chronic sinusitis
• Excessive coughing
• Inhaling irritants, such as allergens or toxic fumes
• High alcohol intake
• Habitual misuse or overuse of voice
• Smoking, including secondhand smoke
• Inhaling steroid medicines, such as asthma inhalers
• Bacterial, fungal, or parasitic infections
• Allergies
• A sinus infection
• An injury to the vocal cords or growths on the vocal cords
• Laryngeal malignancy

Laryngitis can be acute or chronic, infectious or noninfectious. Acute laryngitis is usually self-limiting and lasts for less than 7 days. Chronic laryngitis is the presence of laryngeal inflammatory symptoms including hoarseness, globus, pain, dysphagia, throat clearing, or cough lasting more than 3 weeks. A thorough evaluation and specialist consultation should be obtained to evaluate for inflammatory, infectious, or autoimmune etiologies, and because chronic laryngitis can mimic symptoms of laryngeal malignancy.

Traitement

Dans sa forme classique la laryngite guérit sans traitement. Cependant, certaines formes peuvent engager le pronostic vital et nécessité une hospitalisation

Traitement

Type de laryngite	Prise en charge
Laryngite catarrhale de l'adulte	En général la guérison survient sans traitement, certains cas peuvent nécessité: un repos vocal'mesures hygiéniques' ( arrêt tabac, caféine, alcool, repas épicés, chocolat..) inhalation à vapeur antalgique/ antipyrétique antibiotique en cas de laryngite bactérienne avérée
Laryngite sous-glottique	patient avec état général conservé: inhalation à vapeur+/-corticothérapie (discutée) Patients avec état général altéré: hospitalisation, oxygène humidifié, épinéphrine racémique, corticothérapie

L'évaluation en ORL n'est en général pas nécessaire sauf pour les cas ayant nécessité une admission en urgence et/ou hospitalisation

En cas de persistance des symptômes au delà de 2semaines doit faire crainte une transition vers une laryngite chronique et dans ce cas, il faut rechercher les facteurs de risques et/ou le terrain (immunodépression, un cancer... )

Il est important de noter que l'usage de la corticothérapie est discutée et son intérêt n'a pas été démontré

The treatment of laryngitis in adults depends on the underlying cause and severity of the condition. In most cases, laryngitis is self-limiting and resolves on its own within a week or so. The following are the recommended treatments for laryngitis in adults

:

• Resting the voice as much as possible
• Drinking plenty of fluids to keep the body hydrated
• Using a humidifier to relieve dry throat symptoms
• Avoiding whispering, which can strain the vocal cords more than speaking normally
• Avoiding smoking and exposure to secondhand smoke
• Avoiding alcohol and caffeine, which can dehydrate the body
• Avoiding spicy and acidic foods, which can irritate the throat
• Taking over-the-counter pain relievers such as acetaminophen, naproxen, or ibuprofen to relieve discomfort
• Antibiotics: If laryngitis is caused by a bacterial infection, the healthcare provider may prescribe antibiotics.
• Corticosteroids: These drugs help reduce swelling and inflammation. The healthcare provider may prescribe these in some situations.
• Antifungals: If the laryngitis is related to a candida or yeast infection, antifungal medication may be given.

In cases of chronic laryngitis, the treatment is aimed at treating the underlying causes, such as heartburn, smoking, or excessive use of alcohol. If the laryngitis lasts for more than two weeks or is chronic, the doctor may refer the person to an ear, nose, and throat (ENT) specialist for further evaluation and treatment.

Here are some possible treatments for laryngitis:

- **Resting the voice**: One of the most important treatments for laryngitis is to rest the voice. This means avoiding talking or singing as much as possible, and avoiding whispering, which can strain the vocal cords even more[1].

- **Drinking plenty of fluids**: Drinking plenty of fluids can help to keep the throat moist and reduce irritation[1].

- **Avoiding irritants**: Avoiding irritants such as smoke, alcohol, and caffeine can help to reduce inflammation and irritation in the throat[1].

- **Medication**: Depending on the cause of the laryngitis, medication may be prescribed. For example, antibiotics may be prescribed if the laryngitis is caused by a bacterial infection[1]. In some cases, corticosteroids or other anti-inflammatory medications may be prescribed to reduce inflammation and swelling in the larynx[2].

- **Physical therapy**: Physiotherapy treatment may be recommended to help relieve symptoms of laryngitis. This may include inhalation therapy, which can help to reduce inflammation and swelling in the larynx[3].

- **Voice therapy**: Voice therapy may be recommended for chronic laryngitis or for people who use their voice professionally. Voice therapy can help to improve vocal technique and reduce strain on the vocal cords[4].

- **Surgery**: In some cases, surgery may be necessary to remove vocal cord nodules or polyps that are causing laryngitis[5].

It is important to follow the recommended treatment plan and to seek medical attention if symptoms persist or worsen.

Citations:

[1] https://pubmed.ncbi.nlm.nih.gov/18328379/

[2] https://pubmed.ncbi.nlm.nih.gov/24592580/

[3] https://www.semanticscholar.org/paper/efec3dec1df147b750612ff485f05a6fc37a9cc7

[4] https://pubmed.ncbi.nlm.nih.gov/26043420/

[5] https://www.semanticscholar.org/paper/ae89d872c586cadc36b1b284edcae5ffe6640e06

By Perplexity at https://www.perplexity.ai/search/5494987b-73c2-4af1-bef0-6e804fb2c76d

Suivi

There is no specific follow-up required for acute laryngitis. However, it is recommended to follow the below measures to help the body heal

:

• Resting the voice as much as possible
• Drinking plenty of fluids to keep the body hydrated
• Using a humidifier to relieve dry throat symptoms
• Avoiding whispering, which can strain the vocal cords more than speaking normally
• Avoiding smoking and exposure to secondhand smoke
• Avoiding alcohol and caffeine, which can dehydrate the body
• Avoiding spicy and acidic foods, which can irritate the throat
• Taking over-the-counter pain relievers such as acetaminophen, naproxen, or ibuprofen to relieve discomfort

If the symptoms of laryngitis persist for more than two weeks or are chronic, it is recommended to schedule an appointment with a healthcare provider. In such cases, the healthcare provider may refer the person to an ear, nose, and throat (ENT) specialist for further evaluation and treatment.

Acute laryngitis is an inflammation of the mucous membrane of the larynx, which is accompanied by a violation of the voice function. The follow-up in acute laryngitis depends on the severity of the symptoms and the underlying cause. Here are some possible follow-up measures:

- **Medication**: Depending on the cause of the laryngitis, medication may be prescribed. For example, antibiotics may be prescribed if the laryngitis is caused by a bacterial infection. In some cases, corticosteroids or other anti-inflammatory medications may be prescribed to reduce inflammation and swelling in the larynx.

- **Physical therapy**: Physiotherapy treatment may be recommended to help relieve symptoms of acute laryngitis. This may include inhalation therapy, which can help to reduce inflammation and swelling in the larynx.

- **Personal care**: Resting the voice, drinking plenty of fluids, and avoiding irritants such as smoke and alcohol can help to relieve symptoms of acute laryngitis.

- **Follow-up appointments**: In some cases, follow-up appointments with a healthcare provider may be recommended to monitor symptoms and ensure that the laryngitis is resolving.

- **Further evaluation**: If symptoms persist or worsen, further evaluation may be necessary to rule out other underlying conditions, such as herpes zoster infection or vocal cord inflammation.

It is important to follow the recommended treatment plan and to seek medical attention if symptoms persist or worsen.

Complications

Les complications de cette maladie sont :

• la complication 1
• la complication 2
• la complication 3
• ...

Complications of laryngitis can occur if the condition is not treated properly or if it is severe. Here are some possible complications of laryngitis:

- **Laryngeal obstruction**: Acute laryngitis can cause swelling and inflammation of the larynx, which can lead to a partial or complete blockage of the airway. This can be life-threatening and requires immediate medical attention[1].

- **Chronic laryngitis**: If laryngitis persists for more than three weeks, it is considered chronic. Chronic laryngitis can lead to permanent damage to the vocal cords and a loss of voice[2].

- **Vocal cord nodules or polyps**: Repeated episodes of laryngitis can cause the formation of nodules or polyps on the vocal cords, which can affect voice quality and require surgical removal[2].

- **Aspiration pneumonia**: If laryngitis affects the ability to swallow properly, food or liquid may enter the lungs and cause pneumonia[2].

- **Spread of infection**: If laryngitis is caused by a bacterial or viral infection, the infection can spread to other parts of the respiratory system, such as the lungs or sinuses[2].

It is important to seek medical attention if symptoms of laryngitis persist or worsen, especially if there is difficulty breathing or swallowing.

Citations:

[1] https://www.semanticscholar.org/paper/7da5535f2ce2870cf546a8ddca23a3e70a5ae09e

[2] https://www.semanticscholar.org/paper/efec3dec1df147b750612ff485f05a6fc37a9cc7

By Perplexity at https://www.perplexity.ai/search/d2286229-90ff-492a-a96b-f0b838b29e3f

Évolution

La laryngite aiguë est généralement une affection autolimitante, de ce fait son pronostic est très souvent favorable. Dans de rare cas elle peut avoir une symptomatologie bruyante pouvant mettre en jeu le pronostic vital du patient.

Prévention

En évitant de contracter les virus en lien avec la laryngite virale (mesure d'hygiène), il est possible d'éviter d'en fa