A Case Report on Laryngeal Histoplasmosis Masquerading As Tuberculosis

Laryngeal histoplasmosis is a rare manifestation of infection by Histoplasma capsulatum, typically resulting from hematogenous dissemination following a primary pulmonary infection. However, primary laryngeal involvement without prior lung disease is uncommon and can present a diagnostic challenge. The disease often mimics laryngeal malignancies or other chronic inflammatory conditions due to its nonspecific symptoms, including progressive hoarseness, dysphagia, odynophagia, fatigue, malaise, and weight loss. Risk factors include immunosuppression, such as HIV/AIDS, prolonged corticosteroid use, or other conditions leading to impaired cellular immunity. Diagnosis requires a high index of suspicion, particularly in endemic regions, and is confirmed through histopathological examination, fungal cultures, or molecular testing of laryngeal biopsy specimens. Due to its rarity, misdiagnosis is common, leading to delays in appropriate antifungal therapy, which primarily consists of itraconazole or amphotericin B in severe cases. Early recognition and treatment are crucial to prevent complications and improve patient outcomes. This report highlights the need for increased awareness of laryngeal histoplasmosis among clinicians to facilitate timely diagnosis and management. We report the case of a 25-year-old male presented with dysphagia and increasing hoarseness of voice over three months, initially suspected to have tuberculosis (TB) but later diagnosed with primary laryngeal histoplasmosis.