31 year old male teacher with history of allergic rhinitis and post nasal drip since 2 months had throat irritation since one month complaining only while swallowing own saliva there was no voice problem But during his laryngeal irritation and pain he continued teaching with several analgasic course gargle and antibiotics which helps slightly but did not heal completely He consulted with two ENT specialist but bot have diagnosed only mild redness and congested throat and no other problem There was no fever no other symptom He kept teaching during this phase Now from 2 days suddenly patient complaining of voice horseness with almost complete lost of voice With severe nasal congestion with mild fever and rhinitis with cough and mucous production Patient was prescribed Azithromycin 500 mg OD for 3 days Prednisolone 5mg BD With nasal decongestant and analgesic And cough suppresent Patient was on complete rest with voice rest in last two days Other symptom are resolved within 2 days And voice has improved but still patient can not speak normally also throat irritation and burning is present Since 2 days patient is inhaling steam with frequent saline garlge There is no systemic illness or symptom What is prognosis and treatment Is this prolonged pharyngitis is due to continued teaching with pharyngitis And this leads to laryngitis Or something else may be related like Tuberculous laryngitis How much time it may take to be normal again Share your views drs

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This patient is a teacher by profession, needs , 1 ) Thorough history taking including, Family history of allergic rhinitis, hay fever, Bronchial asthma and any kind of Type 1 hypersensitivity. 2 ) StX-ray PNS OM view, Digital. 3 ) CBC, CRP, ASO titre, Serum IgE total and specific IgE estimation , TFT FPG, PPPG, HbA1C, Calcium and 25OH Vitamin D. 4 ) Throat swabs and posterior nasal swab for Gram's stain and C / S. 5 ) Lary

5 ) Laryngoscopic findings. Getting these results may pinpoint diagnosis or reports will give lead for further investigations needed to establish a pinpoint specific diagnosis and then treatment accordingly.
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Do CT PNS... and laryngioscopy.... Chances of Pan sinusitis with vocal nodule or singer's nodule on vocal cord... causing hoarse voice.. Needs speech therapy with voice rest for some days Tab.Monteleucast with levocetrizine 1od Tab.Cefuroxime axetil 500mg bid for 7 days Tab.Mucolite bid Tab.Deflazecort 6mg bid for 5 days then 6mg od for 5 days.. If CT PNS suggest any obstructive pathology with pan sinusitis... patient may need FESS... and if vocal nodule is present and not resolved by Short course steroid need Laser microlaryngeal surgery.. If cough is troublesome and present with chronic bronchitis go for sputum for AFB also... Do accordingly..

I agree with Dr.S.Revadekar
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Apart from Dr.Sushant advised, I will further add that patient's main problem is chronic sinusitis which leads to POST NASAL DRIP that continuously irritate his posterior pharynx causing him to cough more.Additionally his teaching job aggravates his larynx causing more hoarseness.My advise will be more STEAM INHALATION with Inhalade plus drops 5 drops to be added in hot water before inhalation EVERY 2 HOURLY & COMPLETE REST TO THE VOICE. Instead of Deflazecort TAB.PREDNISOLONE 5MG in tapering doses for 15 days (1---1---15days then 1---15days then 1 OD for 5 days ).Rest is as Dr.Sushant prescribed. I think he should be alright with this advice n medication.

Tab.PREDNISOLONE 1-----1-----1 5 days 1------------1 5 days 1 5 days AFTER FOOD OR WITH MILK.
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X Ray PNS. Check Vit D3 level. CBC. Blood sugar levels.

It is pharyngitis complicated with laryngitis.Along with accessary measure one Homeopathic drug can do marvel and that is Causticum 30, 1 dose. Saline gurgle+ complete voice rest.

Mucous membranes are affected and the fauces inflammed. Tongue thickly coated. The patient could teach in spite of laryngitis means a prolonged sub acute condition. This condition is the result of sour food and drinks OR beer. Kali bichro 200 single dose can improve better than any other antibiotics with corticosteroid inhalers. Please give a dose Resolution should be rapid.

Story looks like poorly treated laryngitis with sinusitis and tonsillitis in professional voice user. Agress treatment of with antibiotics decongestant antiallergic analgesics steam inhalation will get him working again.needs to control sinusitis tonsillitis and speech therapy on long run to avoid recurring.

I agree with Dr Sushant.and patient required .homeopathic treatment as case is chronic and patient receive all multiple medicines. And occupationally teacher.then give stat dose nux vomica 1m stat and on every weak on Sunday bid dose. And start barita carb 30 bid for hoarseness due to overuse of voice.and I require his thirst and bowel complaint to give him constitutional remedy

Agree with Dr Gupta

@Dr. Parshant Aggarwal Could be oral candida try betadin gargle. Ask about oral sex?

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