Diagnosis
The diagnosis “laryngitis” is first of all made on the basis of the patient’s clinical appearance. This can be supported by laryngoscopy (a laryngoscopy that can be performed directly or indirectly). In the case of an existing inflammation, this provides a typical picture of redness, swelling and possibly also deposits of mucus or the protein fibrin. If symptoms have already existed for a longer period of time (more than three weeks), a mucosal sample (biopsy) should be taken during a direct laryngoscopy under general anesthesia to examine it under the microscope for degeneration in order to exclude cancer of the throat.
Risk of infection
Whether an inflammation of the larynx (laryngitis) is contagious depends on the cause of the laryngitis. In many cases, an acute laryngitis is caused by an infection with a virus or, more rarely, with a bacterium. In these cases the acute laryngitis is quite contagious for the surrounding area.
The acute form of laryngitis can affect different levels of the larynx (supraglottis, glottis, subglottis). Depending on the floor of the larynx affected, a different spectrum of pathogens is typical. Laryngitis supraglottica, also known as epiglottitis, is a life-threatening inflammation of the epiglottis, which in children is usually caused by the bacterium Haemophilus influenzae type B (Hib).
In the meantime, however, it occurs only rarely, since the Standing Vaccination Commission (STIKO) recommends vaccination against the triggering bacterium (Haemophilus influenzae). In the case of an infection with Haemophilus influenzae type B, transmission from person to person via a droplet infection can occur. It is particularly dangerous for small, unvaccinated children.
If adults contract epiglottitis, it is usually caused by other bacteria such as streptococci, staphylococci or pneumococci. Of course an infection with these bacteria is also contagious. Laryngitis subglottica is also called pseudocroup and is mostly caused by a viral infection.
However, it is quite possible that a bacterial infection may be added, in which case it is called a bacterial superinfection. In most cases such a bacterial superinfection occurs with the bacterium Haemophilus influenzae. Laryngitis subglottica is therefore also contagious.
Viruses and bacteria that cause colds or even laryngitis are spread and transmitted into the environment in the form of tiny droplets (droplet infection), as they occur when speaking, coughing or sneezing. To avoid infection, close contact with sick people should be avoided as far as possible. In addition, overcrowded trains or waiting rooms are a frequent source of infection in winter.
In addition to aerogenic infection, i.e. infection via the airway by inhaling infectious droplets, bacteria and viruses can also adhere to objects. If these objects are then touched with the hands and the person then touches the mouth or nose, infection can also occur in this way. Smokers and people with already irritated mucous membranes are particularly at risk.
Unfavorable for the mucous membranes are for example working in dusty environments, smoking cigarettes or unfavorable weather conditions. How long an acute laryngitis is contagious and how high the rate of infection is depends on the pathogen that causes it. A chronic laryngitis, on the other hand, is not contagious in most cases, as it is largely not caused by an infection with a virus or a bacterium. If chronic laryngitis is caused by one of the following factors, it is not contagious: nicotine abuse, regular exposure to dusty environments, excessive vocal stress and the rise of acidic stomach acid (gastroesophageal and laryngopharyngeal reflux). Of course, even in these cases an infection with a pathogen can be added and cause a possible contagion.
