Clinical symptoms, endoscopic imaging and stroboscopic imaging in patients with laryngeal fungal infection : An evaluation in 48 patients

Abstract

Introduction: Aspergillus fumigatus and Candida albicans are the most common pathogenic fungi found in Vietnam. Fungal laryngitis has yet to be thoroughly investigated due to the rarity of the disease. This study aimed to describe the clinical, endoscopic and stroboscopic imaging characteristics among patients with fungal laryngitis.
 Methods: A cross-sectional study was performed on 48 patients diagnosed with fungal laryngitis at the Endoscopy Department of the National Ear- Nose-Throat Hospital of Vietnam from August 2019 to March 2020. Clinical, endoscopic and stroboscopic imaging characteristics among patients with fungal laryngitis were reported.
 Results: The rate of fungal laryngitis was higher in men compared to women (men/women ratio: 2.2/1). All patients had dysphonia (100%), while other symptoms included coughing (64.6%) and foreign body sensation (50%). In laryngeal endoscopy, fungal pseudo-membrane was thick with white layer (56.3%) on the vocal cords (100%). In laryngeal stroboscopy, less than half of patients had mucosal wave formation (47.9%). The success rate of fungal culture identification was not high (41.7%), with Aspergillus fumigatus as the main pathogenic fungus (90%).
 Conclusions: Patients with fungal laryngitis in our setting developed prolonged dysphonia. By using endoscopic imaging and stroboscopic imaging, layers of fungal pseudo-membrane on the vocal cords could be observed and extracted for diagnosis.