PRIMARY LARYNGEAL ASPERGILLOSIS IN AN IMMUNOCOMPETENT PATIENT
Background. Aspergillus is an inherently ubiquitous, weakly pathogenic fungus causing opportunistic infections. It is very rarely localized in the larynx, although laryngeal Aspergillosis may develop in the immunocompromised patients including those with leukaemia and severe aplastic anaemia.
Objective. The aim of the research was to explore the primary laryngeal Aspergillosis in an immunocompetent patient thru a case report.
Methods. A case report of primary laryngeal Aspergillosis in an immunocompetent patient is presented.
Results. A male patient of 40 years old, presenting with chronic worsening hoarseness, was found to have a smooth, white spheroid submucosal growth on left vocal cord with preserved bilateral cord movements on videostroboscopy. Histopathological examination of vocal cord growth revealed squamous epithelium containing septate hyphae with acute angle dichotomous branching pattern consistent with Aspergillus. Voice improved after a four-week course of oral itraconazole 200 mg/day. Post therapy follow up of 24 months was unremarkable.
Conclusions. Primary laryngeal Aspergillosis develops in the immunocompetent patients. Iatrogenic, vocal abuse, occupation and lifestyle factors may be contributory. Optimal diagnosis and management mandates a high index of suspicion.
Agarwal P, Yadav RP, Upadhyay SN. A new method of detection and differentiation of pathogenic from non-pathogenic Aspergillus species. Journal of Medical Microbiology. 2001 Jul;50(7):653-4.
Athanassiadou F, Kourti M, Papageorgiou T, Danielidis J. Invasive aspergillosis of the larynx in a child with acute lymphoblastic leukemia. The Pediatric Infectious Disease Journal. 2005 Feb 1;24(2):190-1.
Nagasawa M, Itoh S, Tomizawa D, Kajiwara M, Sugimoto T, Kumagai J. Invasive subglottal aspergillosis in a patient with severe aplastic anemia: a case report. Journal of Infection. 2002 Apr 1;44(3):198-201.
Sriskandabalan P, Roy RB. Aspergillus infection of the epiglottis in a HIV positive patient. Genitourinary Medicine. 1996 Dec;72(6):431-2.
Khan ID, Sahni AK, Sen S, Gupta RM, Basu A. Outbreak of Prototheca wickerhamii algaemia and sepsis in a tertiary care chemotherapy oncology unit. Med J Armed Forces India. 2018 Oct 1;74(4):358-64.
Khan ID, Sahni AK, Basu A, Haleem S. Trichosporon asahii urinary tract infection in immunocompetent patients. Med J Armed Forces India. 2015 Oct 1;71(4):373-6.
Khan ID, Rajmohan KS, Gupta RM, Sen S, Hashmi SA, Ninawe SM, Mukherjee B, Kishore K, Mishra M, Yadav A, Choubey AK. Invasive cerebral and pulmonary mucormycosis in an immunocompromised patient. Journal of Basic and Clinical Medicine. 2017 Nov 13;6(2):9-11.
Gupta AK, Khan ID, Shaw SC, Faisal FA, Sahu S, Khan S, Brijwal M, Shende T, Kundu N, Khalil S, Bhat S. Candida Parapsilosis Neonatal Sepsis. Journal of Basic and Clinical Medicine. 2016 Apr 13;5(1):13-5.
Danish Khan I, Makkar A, Malik A, Khan S, Mehdi I, Arif S, Aden D, Somayaji P, Roomi K. Curvularia Keratomycosis after Cataract Surgery. Journal of Archives in Military Medicine. 2017.
Khan ID, Rajmohan KS, Jindal AK, Gupta RM, Khan S, Shukla M, Singh S, Mustafa S, Tejus A, Narayanan S. Panresistant superbugs: are we at the edge of a ‘microbial holocaust’? International Journal of Medicine and Medical Research. 2017 Dec 29;3(2): 39-44.
Khan ID, Gupta RM, Sen S, Rajmohan KS, Jindal AK, Makkar A, Razi FR, Banerjee P, Panda P, Nair GL, Kulhari K. Emerging antimicrobial resistance and evolving healthcare: Dangerous crossroads for the community and the military. Journal of Archives in Military Medicine. 2017;5(3).
Klein AM, Tiu C, Lafreniere D. Malignant mimickers: chronic bacterial and fungal infections of the larynx. Journal of Voice. 2005 Mar 1;19(1):151-7.
Ogawa Y, Nishiyama N, Hagiwara A, Ami T, Fujita H, Yoshida T, Suzuki M. A case of laryngeal aspergillosis following radiation therapy. Auris Nasus Larynx. 2002 Jan 1;29(1):73-6.
Wittkopf J, Connelly S, Hoffman H, Smith R, Robinson R. Infection of true vocal fold cyst with Aspergillus. Otolaryngology-Head and Neck Surgery. 2006 Oct;135(4):660-1.
Fairfax AJ, David V, Douce G. Laryngeal aspergillosis following high dose inhaled fluticasone therapy for asthma. Thorax. 1999 Sep 1;54(9):860-8.
Khan ID, Gupta N, Rangan NM, Singh R, Sharma AK, Khurana A, Rudra P, Krushnarao MS. Evaluation of pre and post analytical variables in clinical microbiology services in multidisciplinary ICU of a medical college and tertiary care hospital. Journal of Basic and Clinical Medicine. 2016 Apr 5;5(1):2-4.
Khan ID. Challenges and opportunities in diagnosis and management of infectious diseases in developing country healthcare system. Journal of Basic and Clinical Medicine. 2016 Apr 5;5(1).
Beust L, Godey B, Grollier R, Le Gall F, Le Clech G. Primary aspergillosis of the larynx and squamous cell carcinoma. Annals of Otology, Rhinology & Laryngology. 1998 Oct;107(10):851-4.
Kheir SM, Flint A, Moss JA. Primary aspergillosis of the larynx simulating carcinoma. Human pathology. 1983 Feb 1;14(2):184-6.
Morelli S, Sgreccia A, Bernardo ML, Della CR, Gallo A, Valesini G. Primary aspergillosis of the larynx in a patient with Fealty’s syndrome. Clinical and experimental rheumatology. 2000;18(4):523-4.
Ran Y, Lu Y, Cao L, Li C, Dai Y, Yang H, Liu Y, Bai H, Zhang C. Primary laryngeal aspergillosis related to oral sex? A case report and review of the literature. Medical Mycology Case Reports. 2013 Jan 1;2:1-3.
Sundarray C, Panda S, Ray R. Primary vocal cord aspergillosis in a non-immunocompromised host. Journal of the Indian Medical Association. 2011 Mar;109(3):200.
Gangopadhyay M, Majumdar K, Bandyopadhyay A, Ghosh A. Invasive primary aspergillosis of the larynx presenting as hoarseness and a chronic nonhealing laryngeal ulcer in an immunocompetent host: A rare entity. ENT: Ear, Nose &Throat Journal. 2014 Jul 1;93(7):265-8.
Doloi PK, Baruah DK, Goswami SC, Pathak GK. Primary aspergillosis of the larynx: a case report. Indian Journal of Otolaryngology and Head & Neck Surgery. 2014 Jan 1;66(1):326-8.
Khan ID, Sahni AK, Bharadwaj R, Lall M, Jindal AK, Sashindran VK. Emerging organisms in a tertiary healthcare set up. Med J Armed Forces India. 2014 Apr 1;70(2):120-8.
Khan ID, Sahni AK. Bacterial infections and emerging resistance in renal transplant recipients. Bangladesh Journal of Medical Science. 2015;14(1): 14-21.
Khan ID, Basu A, Kiran S, Trivedi S, Pandit P, Chattoraj A. Device-Associated Healthcare-Associated Infections (DA-HAI) and the caveat of multiresistance in a multidisciplinary intensive care unit. Med J Armed Forces India. 2017 Jul 1;73(3):222-31.
Khan ID, Dogra PM, Ramphal SK, Khan S, Konar J, Palit A, Srivastava N, Aggarwal P, Haleem S, Alam S. Polymicrobial infections in a teenaged Renal Transplant Recipient. Journal of Basic and Clinical Medicine. 2015 Jul 30;4(1):37-9.
Khan ID, Lall M, Sen S, Ninawe SM, Chandola P. Multiresistant Elizabethkingia meningoseptica Infections in Tertiary Care. Med J Armed Forces India. 2015 Jul;71(3):282-6
Khan ID, Mukherjee T, Gupta S, Haleem S, Sahni AK, Banerjee S, Konar J. Ochrobactrum anthropic sepsis in intensive tertiary care. Journal of Basic and Clinical Medicine. 2014 Nov 18;3(1):18-20.
Khan ID, Sahni AK, Bharadwaj R, Anwar I, Jain V, Khan S, Chowdhury A, Dwivedi AK, Gupta AK, Zaman S, Alam S. Cerebral toxoplasmosis diagnosed by stereotactic brain biopsy leading to detection of HIV infection. Journal of Basic and Clinical Medicine. 2016 Apr 5;5(1):5-7.
Williams MS, Ali N, Nonaka D, Bloor AJ, Somervaille TC. Fatal invasive aspergillosis of the larynx. Eur J Haematol. 2013 Apr;90(4):354.
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