University of Virginia School of Medicine, Charlottesville, VA, USA.
Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA.
Ann Otol Rhinol Laryngol. 2022 Dec;131(12):1404-1408. doi: 10.1177/00034894211073002. Epub 2022 Jan 11.
To describe a rare presentation of laryngotracheal granulomatous disease secondary to sporotrichosis.
The authors report a case of laryngeal sporotrichosis in an immunocompromised patient, with accompanying endoscopic images and pathology.
RESULTS/CASE: A 72-year-old immunocompromised female with a history of rose-handling presented with a year of hoarseness and breathy voice. Flexible nasolaryngoscopy showed diffuse nodularity; biopsy of the lesions demonstrated granulomatous inflammatory changes, and fungal culture grew . Long-term itraconazole treatment was initiated, with improvement in dysphonia and few residual granulomas on follow-up examination.
When evaluating granulomatous disease of the airway, a broad differential including infectious or inflammatory etiologies should be considered, especially in immunocompromised patients. Adequate tissue samples should be collected to facilitate special staining. The current recommendations for laryngeal sporotrichosis include treatment with a prolonged course of itraconazole.
描述继发于孢子丝菌病的喉气管肉芽肿性疾病的罕见表现。
作者报告了一例免疫功能低下患者的喉孢子丝菌病病例,附有内镜图像和病理学资料。
结果/病例:一名 72 岁免疫功能低下的女性,有接触玫瑰史,出现声音嘶哑和气息声 1 年。软性鼻咽喉镜检查显示弥漫性小结节;病变活检显示肉芽肿性炎症改变,真菌培养生长。开始长期服用伊曲康唑治疗,随访检查时发音障碍改善,少数残留肉芽肿。
在评估气道的肉芽肿性疾病时,应考虑广泛的鉴别诊断,包括感染性或炎症性病因,尤其是在免疫功能低下的患者中。应采集足够的组织样本以方便特殊染色。目前推荐使用伊曲康唑进行长期治疗来治疗喉孢子丝菌病。