Laryngeal Histoplasmosis–Description of Two Cases Autochthonous In Brazil and Review of Literature

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Abstract

Histoplasmosis is primarily an inhalation-acquired mycosis with rare cases of cutaneous inoculation histoplasmosis being described. Although it is the third potentially fatal opportunistic mycosis in patients with AIDS, histoplasmosis infection involving the larynx is a rare manifestation. Mucosal lesions may mimic tuberculosis and malignancy and a high index of suspicion is needed to establish the diagnosis correctly, and must be considered in the differential diagnosis of a patient with hoarseness, diagnosed with histoplasmosis and, moreover, in the differential diagnosis of tumors in the vocal folds, causing hoarseness. Disseminated histoplasmosis may occur in immunocompromised hosts and in those exposed to large inoculums of fungal organisms. We report two cases: one who developed a localized laryngeal histoplasmosis after discontinuing antiretroviral therapy and secondary prophylaxis for this opportunistic disease, and the other with disseminated histoplasmosis who presented in an endemic region (Brazil) with an eroded epiglottic mass.