amphotericin-b and Laryngeal-Diseases

We report a very rare case of disseminated pharyngo-laryngeal histoplasmosis with systemic spread in a 10-year-old, immunocompetent child from Guyana. The main signs were a marked deterioration in his general condition, hepato-splenomegaly, multiple lymphadenopathy and ulcerated pharyngo-laryngeal lesions. The diagnosis was made from brushings of the ulcerative lesions, a lymph node biopsy and serological tests performed in the national reference center for histoplasmosis. The initial treatment was with amphotericin B, which was then replaced by oral itraconazole. We report here the main epidemiological, clinical and therapeutic characteristics.

Topics: Amphotericin B; Antifungal Agents; Child; Guyana; Histoplasmosis; Humans; Itraconazole; Laryngeal Diseases; Male; Paris; Pharyngeal Diseases

To compare the acute effects of single nebulized amphotericin B and budesonide in treating cough-related laryngeal sensations in chronic cough patients, a randomized, single-blind, placebo-controlled, parallel-group trial was performed between two groups with positive and negative results of basidiomycetous (BM) fungi in their sputum culture.. Forty patients presenting with chronic cough lasting 8 weeks or longer, whose sputum could be obtained, were recruited for this study. At the first visit, all patients underwent fungal culture sampling of sputum, capsaicin cough inhalation test, pulmonary function tests, and cough-related laryngeal sensation questionnaire (C-LSQ) consisting of 6 items with a severity scale of 0-5 for each item: (1) a sensation of irritation in the throat (SIT); (2) tickle in the throat; (3) throat clearing; (4) urge to cough; (5) a sensation of something stuck in the throat; and (6) a sensation of mucus in the throat (SMIT). The patients were randomly assigned to receive either nebulizer inhalation of 2.5 mg of amphotericin B (Group A) or nebulizer inhalation of 0.5 mg of budesonide (Group B). The efficacies of each therapy were estimated by the change in C-LSQ score.. There were significant differences in the delta score of item 1 (SIT) and item 2 in the BM-negative group and item 6 (SMIT) in the BM-positive group at 60 min after inhalation between Groups A and B (P<0.05).. The results of this study suggested that appropriate use of single inhalation of budesonide or amphotericin B, which would be selected based on the results of sputum culture, may lead to suppression of cough-related laryngeal sensations, such as SIT or SMIT.

Topics: Administration, Inhalation; Adult; Aged; Amphotericin B; Anti-Inflammatory Agents; Antifungal Agents; Basidiomycota; Budesonide; Case-Control Studies; Chronic Disease; Cough; Female; Humans; Laryngeal Diseases; Lung Diseases, Fungal; Male; Middle Aged; Nebulizers and Vaporizers; Paresthesia; Sensation; Single-Blind Method; Sputum; Surveys and Questionnaires; Treatment Outcome; Young Adult

Topics: Aged, 80 and over; Amphotericin B; DNA Primers; Humans; Laryngeal Diseases; Leishmania infantum; Leishmaniasis, Mucocutaneous; Male; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Sequence Analysis, DNA; Tomography, X-Ray Computed; Treatment Outcome; Turkey

To summarize the clinical datas of thepatients with invasive laryngeal fungal infections in, discuss pathogenesis and treatment methods.. Eleven cases of invasive laryngeal fmycosis who were collected from September 2006 to February 2010 with electronic laryngoscopy, aspirate smear and culture and tissue biopsy for pathological diagnosis, were restrospectively analyzed. Those patients were received iv fluconazole, treatment of Oxygen Atomization of amphotericin B solution and taking itraconazole orally. The hepatic and renal functions of the patients were monitored in the course of treatment.. All the cases were diagnosed of invasive laryngeal mycosis. 1 patient showed liver dysfunction in the second week during treatment. And continuing the treatment after using liver protection drugs. All symptoms of the patients were improved and no recurrence happened during the 1-6 years of follow-up.. Invasive laryngeal fmycosis was correlated with occupation exposure, abusing of antibiotics and low immunity. Laryngeal mycosis was Diagnosised mainly depended on the pathological examination. The positive rates of the secretion smear was low. The effects of iv fluconazole, Oxygen Atomization of amphotericin B 2-4 weeks, and 4 weeks of taking itraconazole orally were safety and reliable.

Topics: Administration, Oral; Amphotericin B; Antifungal Agents; Chemical and Drug Induced Liver Injury; Fluconazole; Humans; Itraconazole; Laryngeal Diseases; Mycoses

We report a case of laryngeal leishmaniasis in a United Kingdom (UK) resident who lived in Spain for 5 years.. The patient presented with a history of hoarseness. He had returned to the UK after spending 5 years in Spain as a retiree. His past medical history includes chronic obstructive pulmonary disease (COPD). Histology of a vocal cord biopsy was suggestive of leishmaniasis and polymerase chain reaction (PCR) test was positive for Leishmania donovani. His use of steroid inhaler probably contributed to his acquiring this extremely unusual infection. He was successfully treated with intravenous amphotericin.. Laryngeal leishmaniasis is an extremely rare infection and is rarely reported in the UK. The ease of travel ensures that many tropical infections may present to UK clinicians.

Topics: Aged, 80 and over; Amphotericin B; Antiprotozoal Agents; DNA, Protozoan; Humans; Laryngeal Diseases; Leishmania donovani; Leishmaniasis, Visceral; Male; Neglected Diseases; Polymerase Chain Reaction; Travel

Histoplasma capsulatum infection involving the larynx is a rare manifestation, especially in immunocompetent individuals and a high index of suspicion is needed to establish the diagnosis correctly. We report a case of a 50-year-old Brazilian man who presented with progressive hoarseness and throat pain for 4 months. Laryngoscopy showed a supraglottic vegetant lesion, and the biopsies chronic granulomatous inflammation without any specific agent. A second laryngoscopy with biopsies was performed and after 17 days of incubation in specific medium, H. capsulatum was isolated. The patient was successfully treated with amphotericin B.

Topics: Amphotericin B; Antifungal Agents; Biopsy; Brazil; Histocytochemistry; Histoplasma; Histoplasmosis; Humans; Laryngeal Diseases; Laryngoscopy; Larynx; Male; Middle Aged

Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed.

Topics: Aged; Amphotericin B; Animals; Antiprotozoal Agents; Chronic Disease; Diagnosis, Differential; Follow-Up Studies; Humans; Laryngeal Diseases; Laryngitis; Laryngoscopy; Leishmania donovani; Leishmaniasis; Leishmaniasis, Visceral; Male; Middle Aged; Radiography, Thoracic; Time Factors; Tomography, X-Ray Computed; Treatment Outcome

Paracoccidioidomycosis (South American blastomycosis) is a systemic infection caused by a dimorphic fungus (Paracoccidioides brasiliensis). It is common in the rural areas of Latin America. The majority of the reported cases come from Brazil, Colombia and Venezuela. Paracoccidioidomycosis is the most important systemic mycosis of the tropical Americas and can affect any organ, causing symptomatic or asymptomatic lesions. Paracoccidioidomycosis can mimic other diseases, which must be considered in making the differential diagnosis. Patients get infected by inhaling mycelia found in the natural environment or rarely from traumatic inoculation via mucous membranes. The most common lesions frequently occur in the buccal pharynx mucosa. Others lesions occur in the larynx, adrenal glands, liver, bones, gastrointestinal tract, lungs and nervous system.

Topics: Agriculture; Amphotericin B; Antiprotozoal Agents; Diagnosis, Differential; Humans; Laryngeal Diseases; Male; Middle Aged; Paracoccidioidomycosis; Pulmonary Disease, Chronic Obstructive; Venezuela

Topics: Aged; Amphotericin B; Animals; Antiprotozoal Agents; Epistaxis; Humans; Laryngeal Diseases; Leishmania braziliensis; Leishmaniasis, Mucocutaneous; Male; Mucous Membrane; Nasopharyngeal Diseases; Nose Diseases

A 58 year old male, chronic smoker, with diabetes mellitus (Type II), residing in Madhya Pradesh presented with dysphagia, hoarseness, odynophagia and significant weight loss. Microlaryngoscopy showed reddish ulcerated area involving valleculae, and pharyngo-epiglottic fold. Histopathological examination showed foamy macrophages containing Histoplasma capsulatum. Patient initially responded to Azoles, relapsed three months after stopping the treatment and presented with oral lesions. Biopsy showed H. capsulatum, histologically as well as on culture. The mycelial phase converted to yeast phase on B.H.I.A. at 37 degrees C confirming the isolate as H. capsulatum. The patient responded well to amphotericin B.

Topics: Amphotericin B; Antifungal Agents; Disease Progression; Histoplasma; Histoplasmosis; Humans; Laryngeal Diseases; Laryngoscopy; Larynx; Male; Middle Aged; Mouth Diseases; Recurrence

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Felty Syndrome; Humans; Laryngeal Diseases; Male; Middle Aged

Laryngeal candidiasis is very rare in the absence of other more proximal diseases in the aerodigestive tract. The lesion shows pseudoepitheliomatous hyperplasia or acanthosis and, given its rarity, may be confused with cancer. In the present paper we report on a 56-year-old male patient who presented with hoarseness. Physical examination of the larynx revealed a hyperplastic lesion involving both vocal cords. The clinical aspect and the risk factor profile of the patient (ten bottles of beer and 40 cigarettes per day) generated the clinical diagnosis of laryngeal cancer. A biopsy was taken. The histopathological examination of the specimen excluded a squamous cell carcinoma; however, it could not provide a clear diagnosis. Laryngeal papillomatosis and tuberculosis, which had been suspected, could be excluded. As the lesion progressed, further biopsies led to the diagnosis of candidiasis. Systemic antimycotic treatment with fluconazol and amphotericin caused a complete remission.

Topics: Amphotericin B; Antifungal Agents; Biopsy; Candidiasis; Diagnosis, Differential; Fluconazole; Follow-Up Studies; Humans; Hyperplasia; Laryngeal Diseases; Laryngeal Neoplasms; Laryngoscopy; Male; Middle Aged; Papilloma; Vocal Cords

Infection of the larynx by Candida is rare and usually accompanies lung or disseminated candidiasis. The incidence of isolated laryngeal candidiasis (ILC) is low, although it may be underestimated. We describe 2 patients with ILC confirmed during autopsy: a 45-years-old male with pulmonary fibrosis and a 4-years-old girl with acute myeloblastic leukemia. Hoarseness and dysphagia are the most common symptoms of ILC. The most effective diagnostic technique is laryngoscopy with specimen culture and/or histopathology. Specimens usually show whitish plaques on the larynx. Most ILC patients have some associated disease and/or predisposing factors, with frequent antibiotic treatment prior to the advent of candidiasis. Intravenous amphotericin B provides the most effective therapy, although other antimycotics are also useful. Early diagnosis and initiation of therapy curtail the disease and can prevent systemic dissemination.

Topics: Adolescent; Adult; Aged; Amphotericin B; Antifungal Agents; Candidiasis; Child; Child, Preschool; Female; Humans; Laryngeal Diseases; Laryngoscopy; Male; Middle Aged

Topics: Adult; Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Drug Carriers; Epiglottis; HIV Infections; Humans; Laryngeal Diseases; Liposomes; Lung Diseases, Fungal; Male

Within the upper aerodigestive tract, histoplasmosis often mimics carcinoma, making prompt and accurate diagnosis imperative. More severe and potentially lethal infections with Histoplasma capsulatum are now being seen as the numbers of patients at the extremes of age, as well as those with compromised immune systems, increase. We reviewed the cases of 115 hospitalized patients with disseminated histoplasmosis. Of these, 9 patients were identified with otolaryngologic manifestations: 4 were infected with human immunodeficiency virus (HIV), 1 was diabetic, and 3 were renal transplant patients. Sites of involvement included the larynx (in 2 cases) and the oral cavity and oral pharynx (in 7 cases). Eight of the 9 patients had a positive biopsy result; the other, a positive culture. Treatment with amphotericin B was generally effective, while the use of newer azole anti-fungal agents were less effective. As the number of immunocompromised patients continues to increase in modern clinical practice, histoplasmosis will undoubtedly be encountered more frequently in the head and neck area.

Topics: Amphotericin B; Histoplasmosis; HIV Infections; Humans; Itraconazole; Laryngeal Diseases; Laryngeal Neoplasms; Laryngoscopy; Male; Middle Aged; Retrospective Studies; Stomatognathic Diseases; Treatment Outcome

A patient suffering from persistent hoarseness was eventually shown to have laryngeal leishmaniasis. The incubation period for the disease must have been at least 16 years, following infection in Southern Europe. Mucosal leishmaniasis is rare in the Eastern hemisphere, and laryngeal leishmaniasis has not previously been reported in the UK. Previous Mediterranean cases have run a similar chronic course and have caused diagnostic difficulty, in particular being mistaken for malignancy. Treatment with aminosidine was ineffective, but the patient responded to liposomal amphotericin.

Topics: Amphotericin B; Animals; Female; Humans; Laryngeal Diseases; Larynx; Leishmaniasis; Middle Aged; Mucous Membrane; Time Factors

Topics: Adult; Amphotericin B; Histoplasmosis; Humans; Laryngeal Diseases; Male

Although infections due to Candida have become increasingly recognized in recent years, laryngeal candidiasis remains a poorly described and infrequently diagnosed manifestation of mucous membrane candidal infection. Seven cases of isolated laryngeal candidiasis (ILC) have been identified at our institution during the past eight years (one before and six after death). Clinical, laboratory, and histopathologic findings from those seven cases, as well as from 12 additional cases reported in the literature, are reviewed. When hoarseness and dysphagia occur in patients with significant underlying disease who are receiving broad-spectrum antimicrobic therapy, a diagnosis of ILC should be considered. The diagnostic procedure of choice is indirect laryngoscopy with specimens submitted for culture and histopathologic study. On confirmation of the diagnosis, amphotericin B is the recommended therapy. Early treatment may limit morbidity and prevent systemic candidal dissemination.

Topics: Adult; Aged; Amphotericin B; Candida albicans; Candidiasis; Child; Female; Humans; Laryngeal Diseases; Laryngeal Mucosa; Leukemia, Myeloid; Male; Middle Aged

Granulomatous diseases caused by infectious agents are being seen more frequently than before. Infection with Histoplasma capsulatum is one such granulomatous disease. This condition may have protean manifestations, with involvement of the larynx of particular interest to the Otolaryngologist. Histoplasmosis of the larynx may present difficult diagnostic problems and may closely mimic carcinoma. A case of histoplasmosis of the larynx treated at the University of Cincinnati Medical Center is presented and used to highlight the mode of presentation and the management of this particular disease. The clinical presentation of histoplasmosis is discussed with emphasis on involvement of the upper aerodigestive tract. The diagnostic tests of practical value are outlined. Amphotericin B is the treatment for this disease entity.

Topics: Aged; Amphotericin B; Diagnosis, Differential; Histoplasmosis; Humans; Laryngeal Diseases; Male

Topics: Amphotericin B; Blastomycosis; Female; Humans; Laryngeal Diseases; Larynx; Middle Aged

Topics: Adult; Amphotericin B; Blastomycosis; Humans; Laryngeal Diseases; Male

Localized laryngeal coccidioidomycosis has been rarely reported and usually is associated with disseminated disease. This paper has described localized subglottic coccidioidomycosis in a 13-month old white boy who presented with persistent stridor. Medical management including intravenous amphotericin B resulted in complete eradication of the subglottic lesion.

Topics: Amphotericin B; Coccidioidomycosis; Glottis; Humans; Infant; Laryngeal Diseases; Male; Respiratory Sounds

Topics: Adult; Aged; Amphotericin B; Blastomycosis; Diagnosis, Differential; Histoplasmosis; Humans; Laryngeal Diseases; Laryngeal Neoplasms; Lip Diseases; Male; Middle Aged; Mouth Diseases; Mouth Neoplasms; Mycoses

Topics: Amphotericin B; Female; Histoplasmosis; Humans; Laryngeal Diseases; Middle Aged; Tongue Diseases

Topics: Airway Obstruction; Amphotericin B; Child, Preschool; Esophageal Diseases; Fungi; Humans; Laryngeal Diseases; Male; Mycoses; Orbit; Respiratory Insufficiency; Tracheal Diseases; Zygoma

Topics: Adult; Aged; Amphotericin B; Diagnosis, Differential; Female; Histoplasmosis; Humans; Laryngeal Diseases; Male; Middle Aged; Otorhinolaryngologic Diseases; Pharyngeal Diseases; Tracheal Diseases

Topics: Adult; Aged; Amphotericin B; Biopsy; Carcinoma, Bronchogenic; Coronary Disease; Diagnosis, Differential; Female; Glottis; Histoplasmosis; Humans; Laryngeal Diseases; Laryngoscopy; Lung Neoplasms; Male; Middle Aged; Mouth Diseases; Oral Manifestations; Palate; Tongue Diseases

Topics: Adult; Agricultural Workers' Diseases; Amphotericin B; Antifungal Agents; Candida; Cheek; Chromoblastomycosis; Cytosine; Fluorine; Granuloma; Humans; Laryngeal Diseases; Male

Topics: Amphotericin B; Histoplasma; Histoplasmosis; Humans; Laryngeal Diseases; Male; Middle Aged

Topics: Amphotericin B; Electrocardiography; Fever; Histoplasmosis; Humans; Laryngeal Diseases; Male; Middle Aged; Nausea; Vocal Cords; Vomiting

Topics: Amphotericin B; Chromoblastomycosis; Diagnosis, Differential; Fungi; Humans; Laryngeal Diseases; Male; Middle Aged; Nystatin

Topics: Amphotericin B; Aspergillosis; Humans; Laryngeal Diseases; Male; Middle Aged; Nystatin; Respiratory Tract Infections

Topics: Addison Disease; Adrenal Gland Diseases; Adult; Aged; Amphotericin B; Chronic Disease; Diagnosis, Differential; Female; Histoplasma; Histoplasmosis; Humans; Laryngeal Diseases; Male; Mechlorethamine; Middle Aged; Mouth Diseases; Oral Manifestations; Tongue Diseases

Topics: Adult; Amphotericin B; Blastomycosis; Humans; Laryngeal Diseases; Laryngoscopy; Male