Acute laryngitis

Acute laryngitis is most commonly a self-limiting inflammation of the larynx (including the vocal cords) that presents with:

  • hoarse voice
  • sore throat
  • mild dysphagia
  • symptoms typical of an upper respiratory tract infection (eg nasal congestion and discharge, fever).

Symptoms typically resolve within 14 daysWood, 2014.

Viral infections are the most common cause of acute laryngitis. Other causes include recent endotracheal intubation, vocal straining, excessive coughing, or inhalation of irritant substances (eg smoke). In children, serious differential diagnoses include croup and retropharyngeal abscess, and in adults and children, acute epiglottitis (supraglottitis).

Note: Do not use antibiotic therapy for acute laryngitis.

Antibiotic therapy is not indicated for acute laryngitisReveiz, 2015Stachler, 2018. Manage symptoms with voice rest, environmental humidification (eg with a humidifier) and analgesia. For suitable regimens of paracetamol or NSAIDs, see here for adults or here for children. Oral corticosteroid therapy is not routinely indicated for acute laryngitisStachler, 2018.

If hoarse voice does not significantly improve or resolve within 4 weeks, refer to an otolaryngologist for examination of the larynxRoyal Australasian College of Surgeons, Last reviewed 10 May 2017Stachler, 2018.

Red flags for early referral includeWood, 2014:

  • stridor (emergency department referral)
  • weight loss
  • difficulty swallowing or painful swallowing
  • persistent hoarseness for 4 weeks or longer in a smoker.