Laryngeal Histoplasmosis Research Articles

Diagnosis and Treatment of Primary Laryngeal Histoplasmosis

Diagnosis and Treatment of Primary Laryngeal Histoplasmosis

Histopathology of a polyploid laryngeal growth revealing disseminated histoplasmosis

Abstract Any polyploid growth in the laryngeal region may be mistaken for a malignant condition. Histoplasmosis of the larynx rarely causes laryngitis; it often masquerades as malignancy or tuberculosis. The other name of this condition is “Cave’s disease” and is caused by the fungus, Histoplasma capsulatum. Here, we report a 54-year-old diabetic male who presented with a history of progressive hoarseness of voice for 6 months. The patient was a chronic smoker for 15 years. A biopsy of the growth was done, and a histopathological examination of the tissue clinched the diagnosis of laryngeal histoplasmosis. The patient was managed with intravenous liposomal amphotericin B and oral itraconazole with complete resolution of symptoms.

Primary laryngeal histoplasmosis: a case report

BackgroundHistoplasmosis is a fungal infection that commonly occurs in the lungs or in disseminated form. Primary laryngeal histoplasmosis is a very rare condition that can mimic laryngeal carcinoma or laryngeal tuberculosis. The purpose of this case report is to highlight the rare occurrence of primary laryngeal histoplasmosis with no involvement of other organs, especially the lungs, the diagnosis dilemma, and the antifungal protocol for this case.Case presentationWe report a case of a 47-year-old male, who is a pigeon breeder, presented with chronic hoarseness. There were no signs of pulmonary or systemic involvement. Biopsy from laryngeal mucosa was confirmed as histoplasmosis, and he was started on intravenous (IV) amphotericin B for 2 weeks and oral itraconazole for 2 months.ConclusionPrimary laryngeal histoplasmosis is considered a very rare occurrence. The laryngeal lesion may mimic conditions such as laryngeal carcinoma and laryngeal tuberculosis. Histopathology examination remains the gold standard, and antifungal treatment is the choice of therapy.

Laryngeal Histoplasmosis in an Immunocompromised Host

Laryngeal histoplasmosis is a rare manifestation of histoplasmosis infection and presents as a diagnostic challenge. It has been documented to occur in immunocompromised and immunocompetent hosts. This is a case of laryngeal histoplasmosis in a patient with idiopathic CD4 lymphocytopenia, an immunocompromising condition that presents similarly to HIV. There is no known cause or standardized treatment of idiopathic CD4 lymphocytopenia, which leaves patients at risk for opportunistic infections and malignancy.

Histoplasmosis of Larynx and Itraconazole as the Treatment of Choice.

Histoplasmosis of Larynx is a very rare anomaly and is usually not seen in an immunocompetent indivual. We present to you a case of 50 year old male, who came to our OPD with complaint of hoarseness of voice. Due to its high probability of mimicking the symptoms of laryngeal carcinoma, differential diagnosis of fungal laryngitis should always be kept in mind. Timely intervention with right diagnosis has very good prognosis in patients with histoplamosis.

Laryngeal histoplasmosis mimicking glottic cancer in an immunocompetent host

We report an interesting case of laryngeal histoplasmosis which clinically mimicked a malignant glottic growth and is unusual in that it involved an immunocompetent host. Also, an isolated laryngeal involvement is very rare. A 63 year old farmer presented with complaints of hoarseness of voice. Indirect layngoscopy revealed a friable growth in the middle of the right vocal cord. Histopathological examination of biopsy taken from the growth showed presence of numerous tiny intracellular organisms within collections of macrophages and epithelioid cells. Confirmation was done with periodic acid Schiff and Gomori’s methanamine silver stain. The patient was administered amphotericin B 1 mg/kg body weight for 2 weeks followed by itraconazole 200 mg, twice a day for 8 weeks and discharged on oral itraconazole. A dramatic improvement in voice quality was seen in follow-up after two months. Repeat endoscopy showed regression of growth. The otolaryngologist should be aware of the existence of laryngeal histoplasmosis and consider it as one of the differential diagnosis when a patient shows signs of granulomatous inflammation or laryngeal masses, to perform specific diagnostic tests for fungi and provide optimal and timely treatment, avoiding unnecessary aggressive interventions.

Three Cases of Laryngeal Histoplasmosis in the Midwestern United States

Three Cases of Laryngeal Histoplasmosis in the Midwestern United States

Histoplasmosis of the Head and Neck in the Immunocompetent Patient: Report of 2 Cases

Histoplasmosis of the head and neck is rarely seen in immunocompetent patients. We report 2 new cases of histoplasmosis of the head and neck in immunocompetent patients, one an 80-year-old man and the other a 57-year-old man. The older man presented with oral cavity histoplasmosis; his symptoms included pain, dysphagia, and ulcerative lesions. The younger man had laryngeal histoplasmosis, which resulted in hoarseness and dyspnea. We discuss the methods of diagnosis and the classic findings in histoplasmosis, including the microscopic appearance of caseating granulomas, the results of periodic acid-Schiff staining and Gomori staining, and antibody detection of histoplasmosis. We also review the treatment options with antifungals, including amphotericin B and the oral conazole drugs. With an accurate diagnosis and proper treatment, both of our patients recovered well and their symptoms resolved. Because their symptoms overlapped with those of other, more common disease processes, an accurate diagnosis of these patients was essential to treating their infection.

Histoplasmosis laríngea: reporte de primer caso en Colombia

Señor Editor.En relación con el artículo “Histoplasmosis laríngea: reporte de primer caso en Colombia” publicado por Moriones et al. Colomb Med (Cali). 2014; 45(4):186-91, deseo realizar los siguientes comentarios:La histoplasmosis es una micosis sistémica frecuente en Colombia y debido a que no es de notificación obligatoria, se diseñó una encuesta nacional para conocer aspectos de la enfermedad que permitió recolectar información de los casos diagnosticados. Hasta el año 2008 se habían analizado 434 encuestas de pacientes provenientes de 20 departamentos, la mayoría de Antioquia, seguido del Valle y Cundinamarca. Por lo tanto, estos resultados no están indicando que la histoplasmosis sea más frecuentemente diagnosticada en estos departamentos como lo expresan los autores, tal vez fueron los que más informaron ya que es un reporte voluntario. La histoplasmosis es causada por el hongo dimórfico Histoplasma capsulatum que presenta dos variedades patógenas para el ser humano, H. capsulatum var. capsulatum e H. capsulatum var. duboisii2, el cual no se adquiere por la inhalación de micelios como es manifestado en el artículo, las estructuras infectantes corresponden a fragmentos de hifas y principalmente las microconidias (2-4 mm) que llegan a los bronquiolos y alveolos pulmonares3. Es importante aclarar que el concepto de micelio corresponde a masa de hifas, por lo tanto, no es correcto sugerir que esta estructura es la responsable de la infección. Posteriormente, las microconidias se transforman en levaduras y debido a la alta actividad fagocitaria de los macrófagos alveolares son fagocitadas y dentro de ellos se multiplican, llevando a veces a la destrucción del fagocito y a la infección de nuevas células4. Luego, el macrófago cargado con el microorganismo es responsable de la diseminación de las blastoconidias a órganos ricos en fagocitos mononucleares. Esto último no corresponde a afirmar que los macrófagos infectados son estimulados a multiplicarse después de la infección como es presentado en el artículo.

Primary Histoplasmosis of Larynx Mimicking as Laryngeal Carcinoma

ABSTRACT Granulomatous diseases caused by infectious agents are being encounted more frequently nowadays. Infection by Histoplasma capsulatum is one such granulomatous disease. Isolated laryngeal histoplasmosis is a rare clinical entity. Because of its simulation with malignancy, it needs to be included in the differential diagnosis of neoplasm, both benign and malignant. We report an extremely rare case of isolated histoplasmosis, presenting as a primary infection of the larynx with no other systemic involvement in a 57 years old immunocompetent male. He presented with progressive hoarseness of voice, difficulty in breathing and mild dysphagia. Indirect laryngoscopy revealed multiple exophytic nodular lesions in endolaryngeal structures. The patient then underwent direct laryngoscopy biopsy under general anesthesia and the histopathological examination of the biopsy revealed chronic granulomatous inflammation, caused by histoplasma which was confirmed by using special Gomori's methanamine silver stain for fungi. Though it appeared like cancer clinically; biopsy confirmed the final diagnosis. The histopathologist must be informed about the possibility of histoplasmosis, because special dyes have to be used to confirm this diagnosis. The treatment is mainly medical with amphotericinB which remains the gold standard for treatment of this disease, although other drugs have also been used. How to cite this article Bist SS, Sandhirr S, Shirazi N, AgrawalV, Bharti B. Primary Histoplasmosis of Larynx Mimicking as Laryngeal Carcinoma. Int J Phonosurg Laryngol 2015;5(1):28-31.

Histoplasmosis laríngea: reporte del primer caso en Colombia

Histoplasmosis es una infección fúngica que es frecuente en Colombia. La histoplasmosis laríngea por lo general se presenta en pacientes inmunocomprometidos por la difusión del hongo desde los pulmones a otros órganos. La enfermedad laríngea aislada (primaria) es rara. Se presenta el caso de un paciente con antecedente de inmunosupresión por trasplante renal, con histoplasmosis laríngea primaria que produjo inflamación granulomatosa supraglótica, tratado con Anfotericina B e Itraconazol, con resolución completa de las lesiones laríngeas.

Laryngeal histoplasmosis: an occupational hazard

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.

Primary Histoplasmosis of Larynx: A Case Series and Review of Literature

Objective: Aim of the study was to analyze 10 managed cases of Primary Histoplasmosis of Larynx, over a period of 10 years. Design: Retrospective, non-randomized, interventional case series. Patients and Method: This study was conducted in the Department of Otorhinolaryngology S.M.S Medical College from 2002 to 2011. The study consisted of evaluation of self-reported and referred patients who presented to ENT OPD and emergency. In all the cases a detailed history and clinical examination was done. All the patients underwent fiber optic laryngoscopy and subsequent direct laryngoscopy and biopsy. CT Scans were obtained for few cases. The study was a retrospective analysis of 10 treated cases. Main Outcome and Measures: Success of the treatment was defined as resolution of symptoms, differ-entiation from malignancy, no recurrence and regular follow up. Result: A total of 10 cases were managed between 2002 and 2011 and were reviewed. The main presentation was hoarseness of voice, with lesion simulating malignancy. Most common site of involvement was false cord and aryepiglottic fold (6 cases). Primary laryngeal Histoplasmosis was essentially a disease of adult males in all 10 cases. Treatment was exclusively medical with use of Itraconazole as drug of choice in 7 cases. Conclusion: Isolated laryngeal Histoplasmosis is a rare entity. Because of its simulation with malignancy it needs to be included in the differential diagnosis of neoplasm both benign and malignant. Our study clearly limits this kind of disease to adult males most commonly involving false cord and aryepiglottic fold in an endophytic pattern. Though it looks like cancer; biopsy confirms the diagnosis. The treatment is mainly medical with Itraconazole being the drug of choice.

Histoplasmosis of the larynx

Histoplasmosis is an infection caused by the fungus Histoplasma capsulatum. Disseminated histoplasmosis rarely presents in the larynx and may mimic the appearance of a laryngeal neoplasm. Here, we present a case of laryngeal histoplasmosis in an elderly patient undergoing treatment for rheumatoid arthritis with immunosuppressive medications.

Hoarseness of voice in an AIDS patient: a rare presenting feature of disseminated histoplasmosis

Laryngeal histoplasmosis is very rare among patients with HIV and very few cases have so far been documented. We report a case of laryngeal histoplasmosis in a patient with no prior AIDS defining diagnosis, which mimicked epithelial neoplasia, and was treated successfully with oral fluconazole.

Laryngeal histoplasmosis in systemic lupus erythematosus: first reported case

Laryngeal histoplasmosis in systemic lupus erythematosus: first reported case

Laryngeal histoplasmosis in an immunocompetent patient from a non‐endemic region: case report

Histoplasma capsulatum infection involving the larynx is a rare manifestation, especially in immunocompetent individuals and a high index of suspicion is needed to establish the diagnosis correctly. We report a case of a 50-year-old Brazilian man who presented with progressive hoarseness and throat pain for 4 months. Laryngoscopy showed a supraglottic vegetant lesion, and the biopsies chronic granulomatous inflammation without any specific agent. A second laryngoscopy with biopsies was performed and after 17 days of incubation in specific medium, H. capsulatum was isolated. The patient was successfully treated with amphotericin B.

Histoplasmose de laringe

A histoplasmose com acometimento único de laringe é uma ocorrência rara da doença, com menos de 100 casos relatados na literatura, quando comparada ao número de pacientes diagnosticados com histoplasmose. Tal localização, quando isolada, pode induzir, erroneamente, ao diagnóstico e tratamento de tuberculose ou câncer de laringe, com casos relatados de tratamentos iniciados para essas doenças. Em um paciente com histoplasmose que desenvolva rouquidão, deve-se pensar no acometimento laríngeo da histoplasmose, enquanto que uma massa laríngea produzindo rouquidão deve incluir em seu diagnóstico diferencial a histoplasmose laríngea. Quando se pensa em histoplasmose como causa de uma lesão laríngea, a biópsia deve ser limitada, removendo a menor quantidade de tecido necessária para o diagnóstico O patologista deve ser avisado da possibilidade do diagnóstico, já que podem ser necessários corantes especiais para o diagnóstico.

Laryngeal Histoplasmosis as a Mimicker of Squamous Cell Carcinoma: Imaging and Histologic Findings

Laryngeal Histoplasmosis as a Mimicker of Squamous Cell Carcinoma: Imaging and Histologic Findings

Histoplasmosis laríngea como manifestación de SIDA

Histoplasmosis laríngea como manifestación de SIDA