Chronic Large Non Healing Ulcer: Non-Tuberculous Mycobacterial Infection of the Laryngopharynx

Hussin, Nurfarissa; Baki, Marina Mat; Sani, Abdullah

doi:10.4082/kjfm.2017.38.5.303

Cited by 6 publications

(16 citation statements)

References 6 publications

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“…An ulcer was found on the right and left hypopharynx and lingual surface of the epiglottis. PCR from the hypopharynx detected a Mycobacterium other than M. tuberculosis , which was not further identified to the species level . A second patient was reported by Wary et al; this patient presented with hoarseness, fever, and pulmonary symptoms for 1 week.…”

Section: Discussionmentioning

confidence: 92%

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Chronic laryngitis caused by Mycobacterium Kansasii in a traveler

et al. 2019

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Chronic laryngitis commonly presents with dysphonia, and infectious causes include tuberculosis and endemic mycoses. We present a 58-year-old female with laryngitis for 5 years, fevers, chills, fatigue, malaise, myalgias, anterior neck pain, and night sweats after multicontinent exposure. Bronchoscopy cultures were negative. Bilateral microflap excision of vocal fold lesions demonstrated thickened epithelium and a deep vocal fold mass. Biopsy showed necrotizing granulomatous inflammation with acid-fast bacilli. Mycobacterium kansasii was identified. Treatment led to improvement in dysphonia, systemic symptoms, and vocal fold irritation. To our knowledge, this is the first case of isolated nontuberculous mycobacterial vocal fold infection.

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Section: Discussionmentioning

confidence: 92%

“…To our knowledge, only three possible patients with M. kansasii infections of the laryngopharynx have been described . This patient is the first instance of isolated vocal cord infection.…”

Section: Discussionmentioning

confidence: 98%

Chronic laryngitis caused by Mycobacterium Kansasii in a traveler

et al. 2019

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“…We found only seven documented cases of laryngeal NTM in the literature [11][12][13][14][15] including the slow-growing Mycobacterium avium, kansasii and malmoense. Presentations included vocal fold mucosal thickening, 11,12,15 multifocal ulcerations 14 and pseudotumor development. 13 To our knowledge, the present case is the first described laryngeal infection by a fast-growing NTM, Mycobacterium fortuitum.…”

Section: Discussionmentioning

confidence: 99%

Atypical Laryngeal Infections: Localized Lesions from Unusual Organisms May Simulate Malignancy

Yan

Taxy

Paintal

et al. 2019

Ann Otol Rhinol Laryngol

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Objective: The identification of rare sources of laryngeal infection in immunocompetent patients. Recovered organisms were Mycobacterium tuberculosis (laryngeal tuberculosis [LTB]), Mycobacterium fortuitum (laryngeal Mycobacterium fortuitum [LMF]), and Blastomyces dermatiditis (laryngeal blastomycosis [LB]). Method: Single institution retrospective case series of three patients over a 2.5-year period and review of the literature on laryngeal infections by three atypical organisms. Results: Three patients presented with hoarseness and cough; one additionally had throat pain (LTB). Indirect laryngoscopy demonstrated diffuse laryngeal ulceration (LTB, LMF) and an exophytic, contiguous glottic mass (LB). Direct microlaryngoscopic biopsies and cultures established the diagnoses, including a frozen section in one case (LB), which prevented a simultaneously planned surgical resection. Appropriate antimicrobial therapy yielded dramatic laryngeal and corresponding vocal improvement, for which we provide unique photo and audio documentation. In the last 10 years, fewer than 500 cases of LTB have been reported in the English language medical literature, principally outside the United States. To date, there have been reports of only 34 LB and no cases of LMF. Conclusion: Atypical infections of the larynx may be localized and mimic laryngeal cancer on endoscopy. Tissue examination as well as microbiologic samples are diagnostic and complementary.

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“…1 While NTM infection most commonly involves the pulmonary system, prior studies have documented head and neck involvement. [2][3][4][5][6][7][8] Laryngeal NTM infections are exceedingly rare. Failure to consider an atypical mycobacterial infection in the differential diagnosis when presented with an ulcerative, exophytic mass may result in insufficient tissue evaluation, delayed diagnosis, and disease progression.…”

Section: Introductionmentioning

confidence: 99%

Nontuberculous Mycobacterial Infection of Larynx and Cervical Trachea

Lau¹,

Lackey²,

Samedi

et al. 2023

Ann Otol Rhinol Laryngol

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Objectives: To present a patient with the first case of NTM (nontuberculous mycobacteria) infection of the larynx extending to cervical trachea, and the first case of subglottic stenosis associated with an NTM infection. Methods: Case report and review of the literature. Results: A 68-year-old female with history of prior smoking, gastroesophageal reflux disease, asthma, bronchiectasis, and tracheobronchomalacia presented with a 3-month history of shortness of breath, exertional inspiratory stridor, and hoarseness. Flexible laryngoscopy demonstrated ulceration of medial aspect of right vocal fold and subglottic tissue abnormality with crusting and ulceration extending through the upper trachea. Microdirect laryngoscopy with tissue biopsies and carbon dioxide (CO2) laser ablation of disease completed, and intraoperative culture revealed positive Aspergillus and acid-fast bacilli with Mycobacterium abscessus (type of NTM). Patient began antimicrobial treatment of cefoxitin, imipenem, amikacin, azithromycin, clofazimine, and itraconazole. Fourteen months after initial presentation, patient developed subglottic stenosis with limited extension into the proximal trachea prompting CO2 laser incision, balloon dilation, and steroid injection of the subglottic stenosis. Patient remains disease free without further subglottic stenosis. Conclusion: Laryngeal NTM infections are exceedingly rare. Failure to consider NTM infection in the differential diagnosis when presented with an ulcerative, exophytic mass in patients with increased risk factors (structural lung disease, Pseudomonas colonization, chronic steroid use, prior NTM positivity) may result in insufficient tissue evaluation, delayed diagnosis, and disease progression.

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Chronic Large Non Healing Ulcer: Non-Tuberculous Mycobacterial Infection of the Laryngopharynx

Cited by 6 publications

References 6 publications

Chronic laryngitis caused by Mycobacterium Kansasii in a traveler

Chronic laryngitis caused by Mycobacterium Kansasii in a traveler

Atypical Laryngeal Infections: Localized Lesions from Unusual Organisms May Simulate Malignancy

Nontuberculous Mycobacterial Infection of Larynx and Cervical Trachea

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