Cryptococcal Laryngitis

Report of a Case and Comprehensive Review of the Literature

Abstract

Introduction 

Cryptococcus neoformans infects immunocompromised and occasionally noncompromised individuals. Cryptococcus neoformans can cause primary localized laryngitis often associated with inhaled corticosteroid therapy. We report a woman with cryptococcal laryngitis who presented with hoarseness and resultant difficulty singing in her church choir.

Case Description 

A 75-year-old asthmatic woman had a 1-year history of hoarseness and difficulty singing in her church choir. The medications are as follows: inhaled mometasone/formoterol, inhaled montelukast, and pantoprazole. She cleans her gutters without mask protection. The examination showed only hoarseness of voice. Strobovideolaryngoscopy revealed nodule on right true vocal cord. Biopsy revealed budding yeasts with a mucicarmine-positive capsule compatible with Cryptococcus species. She was treated with oral fluconazole 400 mg daily and her voice dramatically improved at 6-week follow-up.

Discussion 

Laryngeal cryptococcosis is a localized form of cryptococcal disease. It was first reported in 1975. This is the 33rd reported case of cryptococcal laryngitis. We herein review the literature.