Primary aspergillosis of vocal cord: Long-term inhalational steroid use can be the miscreant.

Abstract

Primary laryngeal aspergillosis is extremely rare, especially in an immunocompetent host. It is commonly found as a part of systemic infection in immunocompromised patients. A case of vocal cord aspergillosis with no systemic extension in an immunocompetent patient on long-term steroid metered dose inhaler (MDI) is presented here, because of its rarity. The present case is a 28-year-old asthmatic female who was on inhalational steroid for 8 years, presented with sudden onset of severe dysphonia for 5 days. Fiberoptic laryngoscopy demonstrated whitish plaque involving right vocal cord, clinically suggestive of fungal laryngitis. Microlaryngeal laser surgery was performed with stripping of the plaque. Histopathology demonstrated ulcerated hyperplastic squamous epithelium with masses of fungal hyphae, which was confirmed to be Aspergillus species on fungal culture. This rare but serious adverse effect of long-term steroid MDI use must be kept in mind while treating an asthmatic patient. We also present a brief review of literature of laryngeal aspergillosis.

• Authors: Arpita Saha, Kaushik Saha, Uttara Chatterjee
• Journal: Biomedical journal (Biomed J) Vol. 38 Issue 6 Pg. 550-3 (Dec 2015) ISSN: 2320-2890 [Electronic] United States
• PMID: 27013456 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

Chemical References

• Fluticasone

Topics

• Administration, Inhalation
• Adult
• Aspergillosis (chemically induced)
• Asthma (drug therapy)
• Female
• Fluticasone (administration & dosage, adverse effects)
• Humans
• Laryngeal Diseases (chemically induced)
• Vocal Cords