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Laryngeal Manifestations of Paracoccidioidomycosis (South American Blastomycosis)
Geraldo Druck Sant'Anna, MD;
Marcelo Mauri, MD;
Jaime Luis Arrarte, MD;
Humberto Camargo, Jr, MD
Arch Otolaryngol Head Neck Surg. 1999;125:1375-1378.
Objective To report clinical manifestations, diagnosis, and epidemiologic characteristics of laryngeal paracoccidioidomycosis.
Design Case series.
Settings Tertiary care institutional hospital.
Patients We reviewed the hospital records of 7 patients with laryngeal paracoccidioidomycosis diagnosed by histopathological examination.
Main Outcome Measure Clinical manifestations of laryngeal paracoccidioidomycosis.
Results All patients were men and were middle-aged (range, 43-65 years), and most (86% [6/7]) were farm workers. All 7 patients regularly used tobacco, but only (43% [3/7]) were alcohol users. Clinical manifestations were dysphonia (86% [6/7]), dyspnea (71% [5/7]), dysphagia (43% [3/7]), and cough (29% [2/7]). Laryngeal examination revealed ulcerative lesions with a mulberry-like appearance in 3 patients and vegetative lesions in 4 patients. Many had multiple laryngeal lesions with involvement of the true and false vocal cords, the epiglottis, and the arytenoid and interarytenoid areas. The first diagnostic impression was carcinoma in all patients.
Conclusions Laryngeal paracoccidioidomycosis may be a difficult diagnosis for the unsuspecting clinician to make. Examination of the larynx can reveal lesions similar to laryngeal cancer; therefore, diagnosis of carcinoma must be ruled out by histopathological examination or culture of a specimen.
From the Department of Otorhinolaryngology, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Complexo Hospitalar Santa Casa, Porto Alegre, Brazil.
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