Blastomycosis of the larynx: causes, symptoms, diagnosis, treatment

Blastomycosis is a group of chronic non-contagious diseases related to deep mycoses affecting the skin, bones, mucous membranes and internal organs. The disease was named Gilchrist syndrome, after the American dermatologist T. Gilchrist (1862-1927), who first described it; this form of the disease, characterized by lung and skin lesions, was also called "North American blastomycosis".

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What causes laryngeal blastomycosis?

Blastomycosis of the larynx is caused by yeast and yeast-like fungi, in particular, as concerns Gilchrist's disease, by Blastomyces dermatidis or Monilia sacharomyecs cryptococcus.

The reservoir of blastomycosis pathogens is soil. Infection usually occurs when inhaling fungal spores with dust. People working in agriculture are mostly affected.

Pathological anatomy of laryngeal blastomycosis

Blastomycosis of the larynx begins with the appearance of small round red papules mainly on exposed parts: face, hands, forearms, etc. Some of the papules soon turn into pustules, which open with the release of purulent-bloody fluid and subsequent formation of crusts. As a result of slow peripheral growth and fusion of the elements of the rash, more or less large infiltrated, slightly painful ulcers with scalloped, raised edges that break off abruptly towards the center are formed. In the center of the lesion, healing occurs with the formation of a scar, closer to the periphery, papillary and warty growths develop, covered with serous-purulent discharge. The skin around the lesion is often dark purple; miliary pustules can be seen in this area.

Symptoms of Blastomycosis of the Larynx

Isolated laryngeal blastomycosis is extremely rare. More often, it occurs together with pulmonary or skin blastomycosis. The latter combination significantly simplifies diagnostics, which is very difficult in the isolated form. Much less often, laryngeal blastomycosis is combined with a similar lesion of the nasopharyngeal mucosa.

In case of laryngeal disease, patients usually present the same complaints as in case of laryngeal sporotrichosis, however, these symptoms of laryngeal blastomycosis are rarely taken into account due to the general severe condition with simultaneously occurring pulmonary blastomycosis.

Diagnosis of laryngeal blastomycosis

Diagnosis of blastomycosis of the larynx is the same as for sporotrichosis of the larynx. During laryngoscopy at the onset of the disease, a dark-red swelling is determined in the area of the epiglottis, aryepiglottic folds and other areas of the mucous membrane of the larynx. Soon, small yellowish nodules appear on this swelling, transforming into pustules containing purulent-bloody fluid. These pustules scar, and in their place, if the disease progresses chronically, new ones appear.

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Treatment of blastomycosis of the larynx

Blastomycosis of the larynx is treated in the same way as sporotrichosis of the larynx.