Cryptococcal laryngitis in an immunocompetent asthmatic patient using inhaled corticosteroids

Area of Science:

• Mycology
• Infectious Diseases
• Pulmonology

Background:

• High-dose corticosteroid use, particularly inhaled corticosteroids, can predispose individuals to opportunistic fungal infections.
• Cryptococcosis is an opportunistic fungal infection typically caused by Cryptococcus neoformans or Cryptococcus gattii.

Observation:

• A patient using excessive inhaled corticosteroids presented with a laryngeal mass lesion after months of symptoms.
• Nasopharyngoscopy revealed the mass, and subsequent biopsy confirmed cryptococcal laryngitis via histopathology and microbiological assessment.

Findings:

• The causative agent was identified as Cryptococcus neoformans var. grubii.
• Treatment with six months of fluconazole resulted in clinical cure and complete resolution of the patient's symptoms.

Implications:

• This case underscores the importance of considering non-Candida fungal infections in patients on prolonged or high-dose corticosteroid therapy.
• Increased awareness is crucial, especially in the post-COVID-19 era, given the more frequent prescription of steroids.