HOARSENESS  SECONDARY TO  LARYNGEAL HISTOPLASMOSIS: A CASE REPORT.

Ahmad Mahfuz ZAMAILI^1,2, Irfan MOHAMAD¹, Hamidah MAMAT², Othman ABDULLAH³.

¹Department of Otorhinolaryngology – Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus 16150 Kubang Kerian,Kelantan, Malaysia.

²Department of Otorhinolaryngology – Head & Neck Surgery, Hospital Sultan Abdul Halim, 08000 Sungai Petani, Kedah, Malaysia.

³Department of Pathology, Hospital Sultan Abdul Halim, 08000 Sungai Petani, Kedah, Malaysia.

ABSTRACT

Histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from lungs to other organs but laryngeal involvement is rare. We report a 52-year-old male chronic smoker who presented with hoarseness for three months was initially investigated for laryngeal carcinoma. However biopsy showed granulomatous inflammation. He was treated with anti-tuberculosis treatment for two months but symptoms persisted and a repeat biopsy revealed laryngeal histoplasmosis. There were no sign and symptoms of pulmonary or systemic involvement. Treatment with intravenous amphotericin B and oral itraconazole lead to complete resolution of symptoms and signs. Monitoring and early revisiting the diagnosis are important when a patient’s symptoms do not improve with the treatment. Further investigation including a repeat biopsy of lesion is vital to establish the diagnosis and lead to appropriate management.

Keywords: Carcinoma, Granulomatosis, Histoplasmosis, Larynx, Tuberculosis.

Corresponding author: Dr Irfan Mohamad, Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia

E-mail: irfankb@usm.my; Phone No: +609-7673000 ext: 6420

ORCID ID: https://orcid.org/0000-0001-8572-0514

Brunei Int Med J.2022;18:16-19