Incidence of Seropositivity to Bordetella Pertussis and Mycoplasma Pneumoniae Infection in Patients With Chronic Laryngotracheitis

Objectives/Hypothesis: Determine the incidence of bordetella pertussis and mycoplasma pneumonia infection in patients with chronic laryngotracheitis. Study Design: A prospective case study Methods: Fifty-four consecutive adult patients presenting with symptoms (throat clearing, hoarseness, cough, globus) and signs (laryngeal and subglottic erythema and edema) of chronic laryngotracheitis (CLTR) for >6 weeks were included in the study. A single blood draw for anti-pertussis toxin IgG, IgA, IgM, and mycoplasma IgM was performed at presentation. Duration of symptoms, symptom score (Reflux Symptom Index [RSI]), and physical exam score were recorded. Results: Thirteen patients (24%) had elevated IgA and IgG to pertussis toxin. Nine patients (17%) had elevated IgM to pertussis toxin. Eight patients (15%) had elevated IgM to mycoplasma pneumoniae. There were no significant differences in symptom duration, RSI score, or Voice Handicap Index-10 score among patients with current infection, recent past infection, or no infection. Subglottic erythema scores were significantly higher for patients with current or recent past infection compared to the no infection group. Patients with current infection or recent past infection had significantly more tracheal erythema than supraglottic or vocal fold erythema. Conclusions: Bordetella pertussis and mycoplasma pneumoniae infection play a significant role in the etiology of CLTR. Pertussis can be a mild but chronic presentation and may not produce typical symptoms of severe cough. Symptom duration and severity cannot differentiate between CLTR of infectious or other etiology. Infection should be considered in patients with CLTR that have significant tracheal erythema.