Which of the following is a rare cause of laryngitis?

NHM UP Staff Nurse-2023 shift 1st

Medical & Surgical Nursing

Medium

Appeared in: NHM UP Staff Nurse-2023 shift 1st

Explanation

Fungal laryngitis is considered a rare cause of voice box inflammation.
It is an opportunistic infection, meaning it primarily occurs in individuals with compromised immune systems.
Patient populations at risk include those with HIV/AIDS, individuals undergoing chemotherapy, organ transplant recipients, or long-term users of inhaled corticosteroids.
In healthy individuals, fungal infections of the larynx are highly uncommon.

Option A: Viral infections are the most common cause of acute laryngitis, not a rare one. They are often associated with upper respiratory infections like the common cold.
Option B: Inhalation of noxious substances (like smoke, chemical fumes, or pollutants) is a common non-infectious cause of laryngitis, not a rare one.
Option C: While less common than viral causes, bacterial laryngitis is not considered rare. It typically arises as a secondary infection following a primary viral illness.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Laryngitis as background academic context rather than a clinical decision trigger.
When a patient presents with persistent hoarseness, it is crucial for the nurse to obtain a thorough history, including immune status and medication use (especially inhaled steroids for asthma/COPD).
Suspecting a rare cause like fungal laryngitis in an at-risk patient can lead to earlier diagnosis and appropriate antifungal treatment, preventing complications.
What if? If a patient with well-controlled asthma who uses an inhaled corticosteroid daily develops persistent hoarseness that doesn't resolve, the nurse should suspect potential oral or laryngeal candidiasis (a fungal infection) and advise the patient to see their provider. Rinsing the mouth after using the inhaler can help prevent this.

How to Approach the Question

First, identify the key term in the question stem: "rare cause". This signals that you need to compare the frequency of the given options.
Recall or deduce the common causes of laryngitis. Most people have experienced laryngitis with a cold, so you can infer that viruses are a common cause.
Consider the other options. Inhalation of irritants like smoke is a well-known cause of coughing and throat irritation, making it a likely common cause.
Differentiate between the remaining infectious agents: bacteria and fungus. In general medicine, primary bacterial infections are more common than primary fungal infections, which are often opportunistic.
Conclude that fungal infections are the least common (rarest) of the choices, as they typically require a specific predisposing condition like a weakened immune system.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 401-403

E6 Medicine Harrison 22e Part 1 p. 301-303

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 2 (215-514) p. 49-51