Zainal Abidin Muhamamad Raziin, Syed Hamzah Al-Yahya Syarifah Nafisah, Mansor Masaany, Abdul Rahim Norazila
Department of Otorhinolaryngology, Hospital Al-Sultan Abdullah UiTM, Bandar Puncak Alam, Selangor, Malaysia.
Department of Otorhinolaryngology, Hospital Al-Sultan Abdullah UiTM, Bandar Puncak Alam, Selangor, Malaysia; Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia.
Int J Surg Case Rep. 2024 Feb;115:109228. doi: 10.1016/j.ijscr.2024.109228. Epub 2024 Jan 9.
Cryptoccous infection or cryptococcosis is a severe opportunistic infection occurring mainly in immunocompromised patients. Laryngeal cryptococcus infection is rare. In an immunocompetent patient, inhaled corticosteroid was reported to be a possible risk factor.
We discuss a case of right vocal fold cryptococcus infection in a healthy, immunocompetent 71-year-old man with no history of inhaled corticosteroid, presented with hoarseness and intermittent aspiration symptom for 1 year duration. Further examination showed right anterior vocal fold mass with presence of right vallecular cyst.
Patient underwent direct laryngoscopy, excision of right vocal fold mass and marsupialization of vallecular cyst. Histopathological examination revealed cryptococcal infection. Patient subsequently treated with oral fluconazole 400 mg daily for 6 months. To date, hoarseness and aspiration symptoms have resolved.
We are sharing our experience in managing laryngeal cryptococcus infection in an immunocompetent patient where the associated risk factors discussed in previous literatures are absent.
隐球菌感染或隐球菌病是一种主要发生在免疫功能低下患者中的严重机会性感染。喉隐球菌感染较为罕见。据报道,在免疫功能正常的患者中,吸入性糖皮质激素可能是一个危险因素。
我们讨论一例71岁健康、免疫功能正常的男性右声带隐球菌感染病例,该患者无吸入性糖皮质激素使用史,出现声音嘶哑和间歇性误吸症状达1年。进一步检查显示右前声带肿物伴右侧梨状窝囊肿。
患者接受了直接喉镜检查、右声带肿物切除术及梨状窝囊肿造袋术。组织病理学检查显示为隐球菌感染。患者随后接受口服氟康唑治疗,每日400毫克,持续6个月。迄今为止,声音嘶哑和误吸症状已消失。
我们分享了在管理一名无既往文献中所讨论的相关危险因素的免疫功能正常患者的喉隐球菌感染方面的经验。