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Laryngeal aspergillosis in an acquired immunodeficiency syndrome patient
C Delbrouck1, G Chantrain, S Kampouridis
1Department of Otolaryngology, C.H.U. Saint-Pierre, Belgium.
Abstract:
Aspergillosis is a rare infection. It varies considerably in its virulence depending on whether or not the patient affected is immunodepressed. The serious form is characterized by vascular invasion with haematogenic dissemination, tissue infarction and necrosis. The most often affected site is the lung. A laryngeal localization is exceptional and usually results from dissemination from a lower airways portal of entry. Diagnosis is difficult: cultures are only positive in 50 per cent of cases, while in 60 per cent of cases the characteristic histological features reminiscent of sprigs of mistletoe are only found on postmortem examination. In view of the high morbidity and mortality in acquired immunodeficiency syndrome (AIDS) sufferers, this condition must be treated early and aggressively. Treatment is based essentially on amphotericin B and itraconazole.
Insights
Aspergillosis is a rare fungal infection, particularly severe in immunocompromised individuals. Early, aggressive treatment with antifungals like amphotericin B is crucial for better outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Pulmonology
Background:
- Aspergillosis is a rare fungal infection with variable virulence, especially in immunocompromised patients.
- Severe cases involve vascular invasion, tissue infarction, and necrosis, often originating in the lungs.
Observation:
- Laryngeal aspergillosis is an exceptional manifestation, typically secondary to lower airway infection.
- Diagnostic challenges include low culture positivity rates (50%) and characteristic histological findings often identified postmortem (60%).
Findings:
- The condition presents significant morbidity and mortality, particularly in individuals with acquired immunodeficiency syndrome (AIDS).
- Characteristic histological features resemble 'sprigs of mistletoe'.
Implications:
- Early and aggressive treatment is essential for patients with acquired immunodeficiency syndrome (AIDS).
- Treatment primarily relies on antifungal medications such as amphotericin B and itraconazole.