Actinomycosis of the larynx

More detailed information about actinomycosis is presented in the article " Actinomycosis of the pharynx ". Here we dwell only on the manifestations of actinomycosis of the larynx, which, as a rule, is associated with actinomycosis of the oral cavity and pharynx.

In rare cases, actinomycosis of the larynx occurs primarily in an isolated form.

[1], [2], [3], [4], [5], [6]

Causes of actinomycosis of the larynx

In classical works, the fungus Actynomyces bovis was used as the pathogen, but from the latest works of the Romanian otorhinolaryngologist V.Racovenu (1964) it follows that Actinomyces Israeli is the true causative agent of actinomycosis.

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Pathogenesis

Actinomycosis of the larynx is manifested by the appearance of nodes on the epiglottis, cherpalodnagortannye and vestigial folds, which undergo decomposition with the formation of fistulas through which a yellow pus-like fluid is released into the laryngeal lumen, containing crumblike inclusions and long branching threads characteristic for actinomycosis, due to which this fungus was called radiant. In ordinary cases, when the cervico-facial region is primarily affected, and the larynx is secondary, in the latter the lesion causes both internal and external perichondrites of the cartilages of the larynx. Simultaneously, cervical lymph nodes are affected, which break up with the formation of external fistulas and disfiguring scars.

Symptoms of actinomycosis of the larynx

Symptoms are manifested in the form of functional disorders - dysphagia and severe breathing difficulties, which are aggravated by secondary swelling of the larynx. Laryngoscopy reveals the changes noted above.

Diagnosis of laryngeal actinomycosis

Diagnosis is difficult with isolated actinomycosis of the larynx. In the initial stage, the actinomycosis of the larynx can be confused with a benign tumor, in the prograde stage - with syphilis, tuberculosis, and cancer. The final diagnosis is established on the basis of clinical data and the results of the study of the discharge from the inflammatory focus, in which actinomycetes druses are found. In addition, diagnostic skin-allergic reactions with actinolysate and a number of other studies are carried out.

[9], [10], [11], [12]

Treatment of actinomycosis of the larynx

Treatment of actinomycosis of the larynx is complex. It includes methods to increase specific immunity by using actinolysate and other immunostimulants, general restorative and stimulating therapy, the appointment of antibacterial, antiseptic and desensitizing drugs, physiotherapy methods, X-ray therapy. The abscesses are widely opened, necrotic tissues and cartilaginous sequestrants are removed.

Prognosis for actinomycosis of the larynx

When the larynx is affected, the larynx actinomycosis has a serious prognosis both for the disability of the patient, doomed to permanent cannulation in case of extensive destruction of the larynx, and in relation to life in the event of acute stenosis and asphyxia. With timely treatment, the disease is curable.