Primary Aspergillosis of the Vocal Cord: A Case Report

Abstract

Background: Primary aspergillosis of the larynx is an extremely rare fungal infection that often mimics malignant or premalignant lesions, making diagnosis challenging. Early recognition is essential to prevent misdiagnosis and treatment delay.

Case Report: A 70-year-old immunocompetent male farmer presented with progressive hoarseness of voice for eight months. Endoscopic examination revealed a whitish irregular lesion involving the right vocal cord. Microlaryngeal excision was performed, and histopathological examination demonstrated septate, dichotomously branching fungal hyphae consistent with Aspergillus. The patient was treated with oral itraconazole (100 mg once daily) for four weeks. Follow-up endoscopy showed complete resolution of the lesion, and investigations excluded pulmonary involvement, confirming primary vocal cord aspergillosis.

Conclusion: Primary vocal cord aspergillosis should be considered in the differential diagnosis of persistent laryngeal lesions, even in immunocompetent individuals. Histopathological confirmation and prompt antifungal therapy result in excellent outcomes.