喉真菌病,在具有系统免疫能力的个体中经常被忽视的情况,需要提高临床警惕性以进行准确诊断。该疾病模仿其他喉部疾病的症状,如胃食管反流,肉芽肿病,角化病,和声门恶性肿瘤,风险因素包括长期使用抗生素,吸入类固醇,和吸烟。临床上,它表现出各种症状,包括声音嘶哑,偶尔疼痛,吞咽困难,和吞咽困难.诊断包括观察角化过度,特别是当上皮内嗜中性粒细胞存在时,通过专门的染色提示进一步研究真菌元素。有效的管理包括延长全身抗真菌治疗和消除诱发因素以防止复发或治疗失败。尽管它有可能模仿一系列喉部疾病,喉真菌病仍然是一个较少考虑的鉴别诊断。一般人群中风险因素的共性加剧了这一点,包括长期使用抗生素,吸入类固醇治疗,和吸烟习惯,这可能会使个体易患喉部真菌感染。此外,高度怀疑和专业诊断技术的必要性,例如通过活检和真菌元素的专门染色鉴定上皮内嗜中性粒细胞过度角化,强调了诊断这种情况的复杂性。记录这个病例报告的理由是多方面的,主要集中在以下事实:喉真菌病在免疫功能正常的患者中很少见,导致系统性免疫功能正常的个体对喉真菌病的认识不足,以及它所带来的诊断挑战。此外,该文件旨在强调对综合治疗方法的迫切需要,包括长期的全身抗真菌治疗以及识别和消除诱发因素,确保有效管理并防止复发。
Laryngeal mycosis, a condition often overlooked in systemically immunocompetent individuals, requires heightened clinical vigilance for accurate diagnosis. The disease mimics symptoms of other laryngeal conditions such as gastroesophageal reflux, granulomatous disease, keratosis, and glottic malignancies, with risk factors including prolonged use of antibiotics, inhaled steroids, and smoking. Clinically, it presents with variable symptoms including hoarseness, and occasionally pain, dysphagia, and odynophagia. Diagnosis involves the observation of hyperkeratosis, notably when intraepithelial neutrophils are present, prompting further investigation for fungal elements through specialized staining. Effective management encompasses prolonged systemic antifungal treatment and the elimination of predisposing factors to prevent recurrence or treatment failure. Despite its potential to mimic a range of laryngeal diseases, laryngeal mycosis remains a less considered differential diagnosis. This is compounded by the commonality of risk factors in the general population, including prolonged antibiotic use, inhaled steroid therapy, and smoking habits, which may predispose individuals to fungal infections of the larynx. Furthermore, the necessity for a high index of suspicion and specialized diagnostic techniques, such as the identification of hyperkeratosis with intraepithelial neutrophils through biopsy and specialized staining for fungal elements, underscores the complexity of diagnosing this condition. The rationale for documenting this case report is multifaceted, primarily focusing on the fact that laryngeal mycosis is rare among immunocompetent patients leading to under-recognition of laryngeal mycosis in systemically immunocompetent individuals and the diagnostic challenges it presents. Additionally, the documentation seeks to emphasize the critical need for comprehensive treatment approaches, including prolonged systemic antifungal therapy and the identification and elimination of predisposing factors, to ensure effective management and prevent recurrence.