Laryngeal papillomas in infants and children. Relationship to maternal venereal warts.

A variety of studies has been directed at establishing the association between human papillomavirus (HPV), as manifested in the adult as a sexually transmitted disease, and laryngeal papillomas found in infants and children. In spite of substantial evidence for the transmission of HPV from women to their infants during childbirth, this association remains unknown to most clinicians in the specialty areas of childbearing and pediatrics. Nurse-midwives find evidence of venereal warts in 1% to 35% (1) of their pregnant clients, depending upon the subpopulation under consideration. A potential sequela of this common gynecologic finding is the growth of papillomas in the larynx of infants who are born to these women. Such growths are not immediately apparent and may be quite difficult to diagnose when they usually become symptomatic, between the ages of two and five years. Clinical symptoms are similar to pediatric findings in croup, asthma, and common upper airway infections. Education of both clinicians and patients regarding potential risks to progeny of infected adults will serve to guide diagnostic attempts in the pediatric population.