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Laryngeal involvement in disseminated coccidioidomycosis
J O Boyle1, S W Coulthard, R M Mandel
1College of Medicine, University of Arizona, Tucson 85724.
Archives of Otolaryngology--Head & Neck Surgery
|April 1, 1991
Summary
Disseminated coccidioidomycosis, a fungal infection, can rarely affect the head and neck, including the larynx. This case highlights a unique presentation in a woman, differing from typical demographics, emphasizing the need for vigilance in diagnosing this rare complication.
Area of Science:
- Mycology
- Infectious Diseases
- Otolaryngology
Background:
- Coccidioidomycosis is a fungal infection endemic to the southwestern US and Mexico, typically affecting the lungs.
- Dissemination occurs in 0.5% of cases, potentially leading to life-threatening complications.
- Head and neck involvement is rare, accounting for 7% of disseminated cases.
Observation:
- A 40-year-old white woman presented with hoarseness and airway compromise.
- The patient was diagnosed with disseminated coccidioidomycosis involving the larynx and cervical lymph nodes.
- This presentation is atypical, as reported cases predominantly affect males, dark-skinned individuals, and children.
Findings:
- Review of 12 laryngeal coccidioidomycosis cases revealed a male predominance (9/12) and frequent pediatric involvement (7/12).
- Nine of the reported laryngeal cases (9/12) presented with airway compromise.
- Other head and neck sites reported include skin, mucosa, skull bones, meninges, and neck abscesses.
Implications:
- This case expands the known demographic profile of laryngeal coccidioidomycosis.
- Early recognition of disseminated coccidioidomycosis is crucial, even in atypical presentations, to prevent severe outcomes.
- Clinicians should consider coccidioidomycosis in the differential diagnosis of hoarseness and airway compromise in endemic areas.