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Case Reports
. 2014 Jan;66(Suppl 1):375-8.
doi: 10.1007/s12070-011-0322-7. Epub 2011 Nov 10.

Fungal laryngitis in immunocompetent patients

A Ravikumar  1 , S Prasanna Kumar  2 , L Somu  1 , B Sudhir  1
Affiliations
Case Reports

Fungal laryngitis in immunocompetent patients

A Ravikumar et al. Indian J Otolaryngol Head Neck Surg. 2014 Jan.

Abstract

The diagnosis of fungal laryngitis is often overlooked in immunocompetent patients because it is commonly considered a disease of the immunocompromised. Further confusion is caused by clinical and histological similarity to more common conditions like Leukoplakia. Demonstration of hyperkeratosis particularly if associated with intraepithelial neutrophils on biopsy should trigger a search for fungus using specialized stains. These patients usually present with hoarseness of voice. Pain is present inconsistently along with dysphagia and odynophagia. We present three cases of fungal laryngitis in immunocompetent patients out of which one underwent microlaryngeal surgery with excision biopsy. All these patients responded well with oral antifungal therapy.

Keywords: Fungal; Immunocompetence; Laryngitis.

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Figures

Fig. 1
Fig. 1
Stroboscopic picture showing white patches over the junction of anterior and middle third of bilateral vocal cord
Fig. 2
Fig. 2
HPE showing stratified squamous epithelium with subepithelial region showing acute on chronic inflammation. Also seen are fungal balls consisting of thin septate hyphae with acute angle branching suggestive of aspergillosis
Fig. 3
Fig. 3
Stroboscopy picture, 2 weeks after the start of antifungal therapy showing well healed vocal cords with improved symptoms and phonation
Fig. 4
Fig. 4
White patch on both tonsils with congested uvula and posterior pharyngeal wall
Fig. 5
Fig. 5
Videolaryngoscopic picture of case 2 showing congested arytenoids and congested edematous vocal cords
Fig. 6
Fig. 6
Stroboscopic picture of the vocal cords showing irregular white patch with erythematous surrounding in the middle 1/3rd of vocal cords typical of fungal laryngitis
Fig. 7
Fig. 7
Post treatment with antifungal of the same patient shown in Fig 6 showing complete resolution of signs
See this image and copyright information in PMC

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