Primary Laryngeal Actinomycosis in an Immunosuppressed Woman: A Case Report

Abstract

We report a rare case of primary laryngeal actinomycosis, which occurred in a 35-year-old woman with end-stage renal failure secondary to systemic lupus erythematosus with membranous glomerulonephritis. The patient, who had been on long-term immunosuppression therapy, presented with hoarseness. Flexible laryngoscopy detected the presence of a granular glottic mass at the anterior commissure of the larynx. Histology revealed actinomycotic organisms associated with an abscess. The patient was treated with a prolonged course of oral penicillin V and speech therapy, and her dysphonia resolved almost completely. Although actinomycotic infection of the larynx is rare, it should be considered in the differential diagnosis of hoarseness in an immunocompromised patient.

Laryngeal abscess formation in an immunosuppressed patient: A case report

“…Laryngeal abscesses have been reported in patients with epiglottitis, tuberculosis, histoplasmosis, sarcoidosis, actinomycosis, laryngopyocele, and immunosuppression, and even has been reported after injection laryngoplasty . Although this pathophysiology remains uncommon, laryngeal abscess formation should remain in the differential for persistent symptoms, especially in cases of patients on immunosuppression.…”

“…Although once more frequent complications of systemic infection, the occurrence of laryngeal perichondritis and abscess formation are now rare . Infectious and inflammatory conditions have led to abscess formation, but this also can be seen in cases of trauma, radiation, foreign body, and immunosuppression . Despite the fact that they are rare, chronic infectious and inflammatory conditions such as histoplasmosis, tuberculosis (TB), actinomycosis, and sarcoidosis have been reported with laryngeal infection and laryngeal abscess formation.…”

“…Although this is far less commonly seen, a report of epiglottic abscess formation was described in a patient with long‐standing diabetes mellitus and a likely compromised immune system that contributed to abscess formation . A case of laryngeal actinomycosis was reported in a patient with long‐standing immunosuppressive therapy due to systemic lupus erythematosus …”

“…1 Infectious and inflammatory conditions have led to abscess formation, 2 but this also can be seen in cases of trauma, 1 radiation, 1 foreign body, 1,4 and immunosuppression. 3,5,6 Despite the fact that they are rare, chronic infectious and inflammatory conditions such as histoplasmosis, 7 tuberculosis (TB), 8 actinomycosis, 6 and sarcoidosis 9 have been reported with laryngeal infection and laryngeal abscess formation. One study revealed 1.7% of patients with head and neck TB have the larynx as the primary site.…”

Laryngeal Actinomycosis in an Immunocompromised Patient

“…2 Rarely, cases have been reported in which actinomycosis affects the larynx primarily. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Here, we present the case of laryngeal actinomycosis that developed in an immunocompromised patient with chronic lymphocytic leukemia (CLL).…”