A 4-Year-Old Boy Is Brought to the Office Due to Hoarseness

A 4-year-old boy is brought to the office due to hoarseness.  The parents report that he has had worsening hoarseness for the past year, and his voice now sounds very raspy and rough.  Flexible laryngoscopy is performed and shows bilateral lesions on the true vocal cords.  Removal of these lesions is performed via direct laryngoscopy.  Histopathologic analysis shows a fibrovascular core with benign squamous cells.  The physician explains to the parents that this is likely due to a viral infection acquired through which of the following routes of transmission?

A) Arthropod vector
B) Direct droplet
C) Indirect contact
D) Vertical direct contact
E) Waterborne

Correct Answer:

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