Three doctors and a mother

Abstract

Laryngeal papillomatosis is a rare and potentially fatal disease characterized by the proliferation of recurrent respiratory papillomas, whose etiology is human papillomavirus (HPV) infection. We report a clinical case of a 21-month girl, whose mother is sero-positive to human immunodeficiency virus (HIV) infection and HPV. This girl attended multiple medical consultations: Development Pediatrics (at the hospital), private Pediatrician and General Practitioner (GP). At 18 months, in the GP surveillance consultation, the concerned mother referred whispered talking, hoarse crying and frequent diagnosis of acute laryngitis at the Pediatrician in the last 3 months. She was referenced to otorhinolaryngology with subsequent diagnosis of laryngeal papillomatosis. The approach to childhood dysphonia avoids inappropriate use of corticosteroids, proton pump inhibitors and antibiotics. This report highlights the disadvantage of the surveillance by multiple doctors and the key role of the GP in gathering and integrating clinical information, allowing the continuity of care.