Management of laryngeal candidiasis: an evidence-based approach for the otolaryngologist.

Purpose: The authors aim to review available reports regarding laryngeal candidiasis and describe the existing evidence on the demographics, clinical manifestations, diagnosis, therapeutic options, and outcomes of this infection.

Methods: A review of articles on laryngeal candidiasis was conducted using PubMed database from its inception through July 2019.

Results: Patients were mainly females presenting with complaints of dysphonia and associated gastroesophageal reflux history or inhaled corticosteroids use; although local predisposing factors were common, most patients were immunocompetent. The main anatomical affected subsite was the glottis with the presence of leukoplastic lesions. The diagnostic approach remains controversial, since some authors recommend prompt lesion biopsy and others rely on empirical antifungal treatment that showed effective results regarding symptoms and lesions resolution.

Conclusion: Laryngeal Candida infection is thought to be a rare condition, with limited available literature. The correct diagnosis is difficult for the otolaryngologist and a high level of suspicion is required. The authors emphasize the need to include this condition into the differential diagnosis in patients with predisposing factors presenting with suspected lesions. In addition, the conservative diagnostic approach with antifungal treatment seems to provide effective outcomes, although comparative clinical studies between diagnostic options are lacking.