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Bacterial Laryngitis in a 12-Year-Old Immunosuppressed Patient

Joe Luchsinger BS, C Burton Wood and Edward B Penn*

Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical School, Nashville, Tennessee, USA

*Corresponding Author:
Edward B Penn
Deprtament of Otolaryngology, Head and Neck Surgery
Vanderbilt University Medical School, Nashville, Tennessee, USA
Tel: (615) 936-8176
Fax: (615) 875-0101
E-mail: [email protected]

Received date: June 22, 2017; Accepted date: June 24, 2017; Published date: June 30, 2017

Citation: Luchsinger BSJ, Wood CB, Penn EB (2017) Bacterial Laryngitis in a 12-Year-Old Immunosuppressed Patient. Pediatric Infect Dis. 2:48. doi: 10.21767/2573-0282.100048

Copyright: © 2017 Luchsinger BSJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 
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Clinical Image

A 12-year-old Amish female with history of biliary atresia and hepatopulmonary syndrome presented for evaluation of persistent dysphonia and previous nasal fungal (Alternaria) infection on the day she was scheduled for liver transplant. Otolaryngology performed flexible laryngoscopy revealing supraglottic and glottic exudate and concern for infection. Direct Laryngoscopy with biopsy and culture revealed extensive colonization with MSSA and Strep G. Transplant was postponed and she was treated micafungin and vancomycin followed by nafcillin for one week. She was discharged on clindamycin and fluconazole therapy for four weeks. Repeat endoscopic examination 3 weeks after discharge showed complete resolution of the exudate (Figures 1-4) [1-3].

pediatric-infectious-disease-Direct-Laryngoscopy

Figure 1: Direct Laryngoscopy with laryngeal exudate.

pediatric-infectious-disease-Thickened-Epiglottis

Figure 2: Thickened Epiglottis secondary to bacterial laryngitis.

pediatric-infectious-disease-Post-debridment

Figure 3: Post-debridment of bacterial exudate.

pediatric-infectious-disease-Flexible-Laryngoscopy

Figure 4: Flexible Laryngoscopy revealing clearance of infection following antibiotic therapy.

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