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Updated: Jan 25, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Laryngeal histoplasmosis in a kidney transplant recipient
Sarwat Khalil1, Douglas W Challener1, Omar Abu-Saleh1
1Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Abstract:
Histoplasma capsulatum is an endemic fungus that most oftenly causes a self-limiting illness but can result in severe infections in immunocompromised patients including pulmonary or extra-pulmonary disease. Rarely it can also cause a chronic progressive infection of the larynx. Herein, we report a case of laryngeal histoplasmosis in a kidney transplant patient who presented with progressive symptoms of several weeks of hoarseness, dysphagia and odynophagia. Laryngoscopic examination revealed thick plaques in the oropharynx with surrounding hyper-erythema and histopathology showed numerous intracellular yeasts forms consistent with H capsulatum. Patient was initiated on treatment with itraconazole. Infection of the larynx due to H capsulatum is highly uncommon and therefore can result in an inappropriate or delayed diagnosis. A review of literature showed four previously reported cases of laryngeal histoplasmosis in patients with solid organ transplant. This is the first case series of laryngeal histoplasmosis in transplant recipients.
Insights
Histoplasmosis can rarely affect the larynx, especially in kidney transplant patients. Early diagnosis and treatment with itraconazole are crucial for managing this uncommon fungal infection.
Area of Science:
- Mycology
- Infectious Diseases
- Transplant Surgery
Background:
- Histoplasma capsulatum is an endemic fungus causing self-limiting or severe infections in immunocompromised individuals.
- Laryngeal histoplasmosis is a rare but serious manifestation, potentially leading to chronic progressive disease.
- Solid organ transplant recipients are at increased risk for opportunistic infections like histoplasmosis.
Observation:
- A kidney transplant patient presented with progressive hoarseness, dysphagia, and odynophagia.
- Laryngoscopy revealed oropharyngeal plaques with erythema.
- Histopathology confirmed numerous intracellular yeast forms of Histoplasma capsulatum.
Findings:
- The patient was successfully treated with itraconazole.
- Literature review identified four prior cases of laryngeal histoplasmosis in solid organ transplant recipients.
- This case series represents the first documented instances of laryngeal histoplasmosis in transplant recipients.
Implications:
- Laryngeal histoplasmosis requires prompt recognition and treatment to prevent complications.
- Increased vigilance for unusual infections is warranted in transplant recipients.
- This study highlights the importance of considering fungal infections in the differential diagnosis of laryngeal symptoms in immunocompromised patients.
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