Cryptococcus Neoformans

Cryptococcus neoformans laryngitis is a rare fungal infection of the larynx.

Cause

The infection usually occurs as a primary pulmonary infection but can spread to other regions of the body.

Symptoms

Common characteristics of cryptococcus neoformans include longstanding hoarseness, sore throat, or edema of the vocal cords.

Treatment

Cryptococcus neoformans laryngitis is treated with oral anti-fungal medications such as fluconazole.

Cryptococcus Infection of the Larynx

Panoramic view (1 of 6)

Panoramic view of laryngeal vestibule in a man with very longstanding hoarseness and sore throat. Note intense redness and bumpy mucosal surface. Biopsy revealed Cryptococcus neoformans.

rough surfaced vocal cords — Closer view (2 of 6)

Closer view of the vocal cords shows similar intense inflammation and rough surface.

smooth mucosal surface — One year later (3 of 6)

After a one-year course of fluconazole, an oral anti-fungal medication. Symptoms are gone. The larynx is no longer inflamed, and the mucosal surface is smooth. White area of scarring (dotted surround), and scar band (parallel dotted lines).

healthy vocal cords — One year later, close-up (4 of 6)

Close-up of the vocal cords shows similar resolution of redness and cobblestoned surface.

4 years later (5 of 6)

The patient has been lost to followup and re-presented with increased hoarseness and sore throat. Here, we see what appears to be recrudescence of the infection with granularity throughout the laryngeal vestibule.

Fungal re-growth (6 of 6)

At closer range, note the granularity of laryngeal petiole and false vocal cords. The vocal cords are in the distance, but also involved by the fungal re-growth.

Resources for Further Reading

Nadrous HF, Ryu JH, Lewis JE, Sabri AN. Cryptococcal laryngitis: case report and review of the literature. The Annals of Otology, Rhinology, and Laryngology. 2004;113(2):121-123. doi:10.1177/000348940411300207

Kerschner JE, Ridley MB, Greene JN. Laryngeal Cryptococcus: Treatment With Oral Fluconazole. Archives of Otolaryngology-head & Neck Surgery. 1995;121(10):1193-1195. doi:10.1001/archotol.1995.01890100097017

Mittal N, Collignon P, Pham T, Robbie M. Cryptococcal infection of the larynx: case report. The Journal of Laryngology & Otology. 2013;127(S2):S54-S56. doi:10.1017/S0022215113000522

Jeng JY, Tomblinson CM, Ocal IT, Vikram HR, Lott DG. Laryngeal cryptococcosis: Literature review and guidelines for laser ablation of fungal lesions. The Laryngoscope. 2015;126(7):1625-1629. doi:10.1002/lary.25749

Worrall DM, Lerner DK, Naunheim MR, Woo P. Laryngeal Cryptococcosis: An Evolving Rare Clinical Entity. Annals of Otology Rhinology & Laryngology. 2019;128(5):472-479. doi:10.1177/0003489419826131

Cryptococcus Neoformans

Cause

Symptoms

Treatment

Cryptococcus Infection of the Larynx

Panoramic view (1 of 6)

Closer view (2 of 6)

One year later (3 of 6)

One year later, close-up (4 of 6)

4 years later (5 of 6)

Fungal re-growth (6 of 6)

Resources for Further Reading

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