Atypical case of fungal laryngitis

Abstract

Results: A patient with no history of pulmonary disease presented to the laryngology clinic with hoarseness and severe odynophagia. The patient was found to have laryngeal inflammation and an exophytic mass in the posterior larynx on laryngovideostroboscopy. After completion of a steroid taper, she had progression of her symptoms, developing stridor. The differential diagnosis included inflammatory and infectious processes, but there was concern for malignancy due to the finding of a laryngeal mass. Direct microlaryngoscopy and biopsies were performed. Pathology revealed yeast forms, and the patient’s urine was positive for blastomycosis antigen. The diagnosis of laryngeal blastomycosis was made. Although she required long-term therapy with oral fluconazole, the patient had dramatic resolution of both her symptoms and her laryngeal findings within one week of initiating treatment.