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Laryngeal Cryptococcosis: An Evolving Rare Clinical Entity.

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Laryngeal cryptococcosis, a rare cause of hoarseness, increasingly affects immunocompetent individuals using inhaled corticosteroids. Diagnosis via biopsy and treatment with oral antifungals are effective.

Keywords:
and risk factorscryptococcusdysphoniahoarsenesslarynxopportunistic infection

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Mycology

Background:

  • Laryngeal cryptococcosis is a rare fungal infection.
  • It presents as persistent hoarseness and vocal lesions.
  • Historically associated with immunocompromised individuals.

Observation:

  • A review identified 29 cases of laryngeal cryptococcosis.
  • Median age was 65; most presented with hoarseness.
  • Lesions often on true vocal cords; 28% immunocompromised.
  • 67% of immunocompetent hosts used inhaled corticosteroids (ICS).

Findings:

  • Diagnosis relies on histopathology; serum antigen tests are unreliable.
  • Persistent hoarseness warrants suspicion in patients with risk factors.
  • Prolonged oral fluconazole is the primary treatment.
  • Laser ablation used for residual lesions.

Implications:

  • Laryngeal cryptococcosis is evolving, affecting more immunocompetent hosts using ICS.
  • Early diagnosis through biopsy and histopathology is crucial.
  • Effective treatment with oral antifungals leads to recovery.