Laryngeal coccidioidomycosis in adults: systematic review of the literature and a case report

Abstract

Abstract BACKGROUND. Coccidioidomycosis spp. is a dimorphic fungus endemic to the southwestern United States and northern Mexico. Incidences in high-risk locations have increased over the last years. MATERIAL AND METHODS. A systematic review has been carried out following the PRISMA guidelines of the reports found in PubMed, Scopus, Google Scholar databases from 1953 to 2023. We included articles written in the English language, with the following keywords “laryngeal” and “coccidioidomycosis” and “adults”, "upper respiratory tract" and "coccidioidomycosis" and "adults". RESULTS. In the review, we could access 8 publications with a total of 10 cases in which 7 men and 3 women were reported, with a mean age of 49.3 years. The ten reported cases were from the southern region of the United States, which borders our state of Sonora in the north. Also, we report the case of a 24-year-old male patient, who presented a chronic picture of more than 1 year with dysphonia, worsening in the last month. He underwent direct laryngoscopy with biopsy, resulting in the diagnosis of laryngeal coccidioidomycosis. Our patient had multiple comorbidities, among which chronic kidney disease in treatment with peritoneal dialysis, erythropoietin and prednisone, with a history of renal transplant in 2017, rejected in 2019. CONCLUSION. Laryngeal coccidioidomycosis is a diagnostic challenge for the clinician, its characteristics may appear to be a malignant entity, up to the formation of abscesses and even present bone destruction. The geographical area in which we are located makes it necessary to always include coccidioidomycosis as a pathology to rule out in our patients.