Sant'Anna G D, Mauri M, Arrarte J L, Camargo H
Department of Otorhinolaryngology, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Complexo Hospitalar Santa Casa, Brazil.
Arch Otolaryngol Head Neck Surg. 1999 Dec;125(12):1375-8. doi: 10.1001/archotol.125.12.1375.
To report clinical manifestations, diagnosis, and epidemiologic characteristics of laryngeal paracoccidioidomycosis.
Case series.
Tertiary care institutional hospital.
We reviewed the hospital records of 7 patients with laryngeal paracoccidioidomycosis diagnosed by histopathological examination.
Clinical manifestations of laryngeal paracoccidioidomycosis.
All patients were men and were middle-aged (range, 43-65 years), and most (86% [6/7]) were farm workers. All 7 patients regularly used tobacco, but only (43% [3/7]) were alcohol users. Clinical manifestations were dysphonia (86% [6/7]), dyspnea (71% [5/7]), dysphagia (43% [3/7]), and cough (29% [2/7]). Laryngeal examination revealed ulcerative lesions with a mulberrylike appearance in 3 patients and vegetative lesions in 4 patients. Many had multiple laryngeal lesions with involvement of the true and false vocal cords, the epiglottis, and the arytenoid and interarytenoid areas. The first diagnostic impression was carcinoma in all patients.
Laryngeal paracoccidioidomycosis may be a difficult diagnosis for the unsuspecting clinician to make. Examination of the larynx can reveal lesions similar to laryngeal cancer; therefore, diagnosis of carcinoma must be ruled out by histopathological examination or culture of a specimen.
报告喉副球孢子菌病的临床表现、诊断及流行病学特征。
病例系列研究。
三级医疗机构。
我们回顾了7例经组织病理学检查确诊为喉副球孢子菌病患者的医院记录。
喉副球孢子菌病的临床表现。
所有患者均为男性，年龄在中年（43 - 65岁），大多数（86% [6/7]）为农场工人。所有7例患者均有规律吸烟，但仅有43%（3/7）饮酒。临床表现为声音嘶哑（86% [6/7]）、呼吸困难（71% [5/7]）、吞咽困难（43% [3/7]）和咳嗽（29% [2/7]）。喉镜检查显示3例患者有桑葚样溃疡性病变，4例患者有赘生性病变。许多患者有多处喉部病变，累及真假声带、会厌、杓状软骨及杓间区。所有患者最初的诊断印象均为癌症。
对于毫无戒心的临床医生来说，喉副球孢子菌病可能难以诊断。喉部检查可能发现与喉癌相似的病变；因此，必须通过组织病理学检查或标本培养排除癌症诊断。
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