Pulmonary tuberculosis in an immunocompetent patient with primary laryngeal aspergillosis

Primary laryngeal aspergillosis in an immunocompetent host is a rare entity. On the other hand, pulmonary tuberculosis (PTB) among healthcare workers in a tuberculosis endemic zone with high risk of exposure is not uncommon but may be underdiagnosed especially when masquerading as another disease. In this report, we are presenting a 45-year-old physician who presented with chronic dry cough, hoarseness of voice, and progressive vocal fatigue. Fibreoptic laryngoscopy (FOL) showed whitish patches on both vocal folds and he was initially diagnosed with laryngeal aspergillosis following histopathological examination. As there was no significant improvement on antifungal treatment, we re-evaluated the case and, on further investigation, concomitant PTB was detected. Patient responded to category-I anti-tubercular drugs with complete recovery.