Primary aspergillosis of the larynx causing acute airway distress

Abstract

Laryngeal aspergillosis is most commonly seen as a secondary infection that spreads from the lungs and tracheobronchial tree. Primary invasive aspergillosis of the larynx is rare and most likely seen in an immunocompromised patient. We present a case of a 59-year-old woman who presented with progressive dysphonia and subsequently acute stridor. She is a non-smoker with a recent diagnosis of acute myeloid leukaemia. Fibreoptic nasendoscopy revealed a left sided vocal cord lesion ball valving into the glottic space. Histology taken during emergency debulking confirmed Aspergillus fumigatus and the patient was successfully treated with intravenous antifungals. Although there are cases of primary laryngeal aspergillosis discussed in the literature, to the best of our knowledge this is the first reported case to have caused acute airway distress requiring emergency intervention.

Case Report: Sudden Fatal Hemorrhage in Ulcerative Fungal Laryngotracheitis—A Pediatric Case Report

“…Invasive Aspergillus laryngotracheitis is a rare clinical variant of invasive pulmonary aspergillosis, characterized by local invasion of the laryngotracheal wall by Aspergillus spp. As it typically affects immunocompromised patients, prolonged neutropenia is recognized among the main risk factors for its onset (18,(26)(27)(28). Considering the typical clinical manifestations associated with invasive laryngotracheal aspergillosis (obstructive/pseudomembranous/ulcerative elements), their coexistence may occur in the laryngotracheobronchial tract, thus leading to a complex clinical picture (18).…”