Laryngitis

I agree with your plan.

Typically these folks have a viral laryngitis which is how his seems to have

started and so only reassurance and supportive measures are needed when that

is the clinical picture.  I wouldn't routinely give PO steroids, but it is

an option.

Sometimes they can get superinfected--I think this kid had a bacterial

laryngitis, but that's uncommon.

Generally, I wouldn't see a fungal laryngitis without a picture of systemic

or local (generally, steroid inhaler for asthma) immune suppression; though,

fungal can occur in immunocompetent folks.

Other things I think about are reflux and post-nasal drip (though typically

hoarseness wouldn't be the prominent Sx).

Larynx cancer (unlikely in a young patient), but this is the primary reason

for them to come get laryngoscopy if Sx persist longer than 4-6 weeks.

If a history of phonotrauma (ex. Screaming at a concert, singer) is present,

then steroids may be helpful.

If longer standing hoarseness, then I would think of benign vocal cord

lesions--papillomas, nodules, cysts, polyp, granulomas, (Granulomas may

improve with reflux treatment, but the others won't), neurologic disorders

(ex. Parkinson's) and functional disorders.

Long story short--supportive care is good, can consider course of PO

steroids, could empirically try PO Abx but low likelihood they will benefit,

and empiric reflux treatment (BID PPI).  Hoarseness lasting >4-6 weeks

should see ENT for a scope (could be sooner if there are other concerning

features--dysphagia, odynophagia, otalgia, weight loss, hemoptysis, F/C/NS).