Laryngeal histoplasmosis: an occupational hazard

Area of Science:

• Mycology
• Infectious Diseases
• Otolaryngology

Background:

• Laryngeal histoplasmosis is uncommon, often presenting with symptoms mimicking benign or malignant lesions.
• It is typically associated with disseminated or pulmonary Histoplasma capsulatum infections.

Observation:

• A 70-year-old Chinese man, a former miner, presented with two months of hoarseness.
• Laryngoscopy showed vocal fold irregularities; histopathology confirmed Histoplasma capsulatum.
• No other systemic involvement was detected.

Findings:

• Primary laryngeal histoplasmosis was diagnosed in the absence of pulmonary or disseminated disease.
• Histopathological confirmation utilized periodic acid-Schiff and Grocott's methenamine silver stains.
• Complete resolution of the laryngeal lesion was achieved after one month of oral itraconazole.

Implications:

• This case underscores the possibility of isolated laryngeal histoplasmosis, emphasizing the need for considering fungal infections in laryngeal pathologies.
• Early diagnosis and appropriate antifungal therapy, such as itraconazole, are crucial for successful outcomes.
• A six-month treatment course is recommended to prevent recurrence of laryngeal Histoplasma capsulatum.