Laryngeal Cryptococcoma Resulting in Airway Compromise in an Immunocompetent Patient: A Case Report

Abstract

Cryptococcus neoformans is a yeast than can result in isolated or disseminated infections. This case report describes an immunocompetent patient presenting with airway obstruction secondary to laryngeal crypotococcoma, mimicking a laryngeal malignancy, and describes associated management. A 68-year-old immunocompetent female with a new positron emission tomography-avid laryngeal lesion was intubated after acute respiratory decompensation. Airway evaluation revealed diffuse mucosal changes throughout the endolarynx with significant loss of normal native tissue architecture. Operative biopsy confirmed infection of C neoformans. The patient was treated with extended-course fluconazole. This case reinforces characteristic physical and histologic findings described for laryngeal cryptococcal infection. Laryngoscope, 2018.

Genotypes and population genetics of cryptococcus neoformans and cryptococcus gattii species complexes in Europe and the mediterranean area

“…niaid.nih.gov/sites/default/files/adccfinal.pdf), are on the rise. Cases of cryptococcosis in these patients are often difficult to diagnose due to the rarity and the different clinical manifestation of the disease (Pappas, 2013;George et al, 2018;Henao-Martìnez et al, 2018;Shuai et al, 2018;Wang et al, 2018;Hamdam et al, 2018;Morse et al, 2018;Florentino et al, 2018;Dioverti et al, 2018;Yamada et al, 2018;Swan and Gottlieb, 2018;Posteraro et al, 2018). Furthermore, cryptococcosis can also occur in immunocompetent hosts, especially when the infection is caused by C. gattii species complex VGI or VGII, making the diagnosis more complicated (Chen et al, 2014).…”

Risk factors of laryngeal cryptococcosis: A case report

“…Laryngeal cryptococcosis is a rare disease, which might be caused by hematogenous spread from lungs or direct deposit by inhaled aerosolized organisms [7]. To our knowledge, less than 30 cases of laryngeal cryptococcosis have been reported [4,8,9] since first described in 1975 [10]. Among cases in which species of Cryptococcus was reported, only one case was caused by C. gattii [7], and the rest were by C. neoformans [4,8,9].…”

“…To our knowledge, less than 30 cases of laryngeal cryptococcosis have been reported [4,8,9] since first described in 1975 [10]. Among cases in which species of Cryptococcus was reported, only one case was caused by C. gattii [7], and the rest were by C. neoformans [4,8,9]. The most recent case reports review of laryngeal cryptococcosis by Wong et al points towards inhaled corticosteroid use, particularly high dose as the most significant risk factor with 45% (10/22) of corticosteroid use by cases [4].…”

“…Except for the patients who were lost to follow-up, all patients including four HIV patients were cured of laryngeal cryptococcosis [4]. All patients had hoarseness or dysphonia [4,8,9]. Rarity of disease, variable nonspecific laryngeal endoscopic findings, and need for tissue biopsy are challenging conditions to make a correct diagnosis [9].…”

“…All patients had hoarseness or dysphonia [4,8,9]. Rarity of disease, variable nonspecific laryngeal endoscopic findings, and need for tissue biopsy are challenging conditions to make a correct diagnosis [9]. Malignancy and fungal infections such as Cryptococcus, Histoplasma, Blastomyces, Coccidioides, and Paracoccidiodes species may be considered when the patients are refractory to empiric local anti-fungal agents or short courses of low dose of fluconazole against suspected Candida .…”