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Laryngeal sporotrichosis: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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Sporotrichosis is a relatively rare human disease that primarily affects the skin and subcutaneous tissue, and in rare cases spreads to the mucous membrane of the upper respiratory tract, particularly the nose, pharynx and larynx.
Sporotrichosis can also affect the nails, eyes, muscles, tendons, joints, bones and internal organs.
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What causes laryngeal sporotrichosis?
Sporotrichosis of the larynx is caused by a fungus of the Sporotrichium family - a filiform spore-bearing fungus. The pathogen has many varieties, including "Russian white streptorichos", described by the Russian dermatologist A.A. Veviorovsky (1913). Sporotrichon vegetates on grasses, shrubs and trees. It can be found on cereals, in flour and street dust, on food products and animals. Infection occurs when the fungus gets on damaged skin or mucous membrane, or it enters the body with food, water and inhaled dust. In the first case, a localized form of sporotrichosis occurs, in the second - a disseminated form of this disease.
Pathogenesis of laryngeal sporotrichosis
When the pathogen penetrates into a damaged area of skin or mucous membrane, a primary lesion (sporotrichous chancre) forms at the site of penetration, which then leads to lymphangitis and new foci. When it enters the gastrointestinal tract and respiratory tract, the fungus, spreading hematogenously, causes various forms of generalized gummatous sporotrichosis. Superficial cutaneous sporotrichosis may resemble ringworm, eczema, impetigo and some other skin diseases. A typical sporotrichosis lesion consists of three zones: a central microabscess; a middle zone characterized by the predominance of acidophilic epithelioid cells among numerous giant and plasma cells; an external fibroplastic zone penetrated by a lymphocytic-plasmatic infiltrate. On the soft palate, epiglottis, aryepiglottic and vestibular folds it appears as infiltrates containing the same elements as the infiltrate in skin lesions.
Symptoms of laryngeal sporotrichosis
Symptoms of laryngeal sporotrichosis differ little from those of other fungal diseases of the larynx, with the exception of actinomycosis. With laryngeal sporotrichosis, patients complain of burning in the pharynx and larynx, a sensation of a foreign body, dysphagia, and sometimes difficulty breathing. Under unfavorable external and internal conditions (humid hot climate, reinfection, weakened resistance, etc.), the disease can progress, spreading along the trachea and bronchi, and hematogenously - everywhere. The course of sporotrichosis is chronic, requiring long-term and systematic treatment.
Diagnosis of laryngeal sporotrichosis
Diagnosis of laryngeal sporotrichosis, if it occurs in isolation, is very difficult and the diagnosis of "laryngeal sporotrichosis" can be reliably made only by histological examination of a biopsy taken from the spirotrichotic infiltrate. Its skin manifestations, which differ from infectious granulomas (tuberculosis, syphilis), as well as another mycosis - Gilchrist's blastomycosis and chronic pyoderma, facilitate direct diagnosis in that sporotrichosis is characterized by multiple foci, their frequent localization on the upper limbs, the presence of lymphangitis, the absence in most cases of a tendency to spontaneous ulceration, the opening of each node with several small fistulous openings, the absence of a core and cheesy masses in the contents of the abscesses, and a dark purple color of the rash. After the ulcers heal, small irregular scars with jagged and pigmented edges remain. Bacterioscopic studies are ineffective, since it is rare to detect fungal elements in pus. To confirm the diagnosis, a fungal culture is isolated and allergic skin and subcutaneous reactions are performed with the fungal culture filtrate, as well as a spore agglutination reaction with the patient's blood serum.
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Treatment of laryngeal sporotrichosis
Laryngeal sporotrichosis is treated by prescribing repeated courses of antifungal agents (Itraconazole, Irunium, Fluconazole, Flumicon, Fungolon), combining them with sulfadimezine, 50% potassium iodide solution in drops. Skin lesions are treated with fucortium (Castellani solution, Lugol's solution and 5% silver nitrate solution). Removal of affected lymph nodes or their opening is contraindicated. In case of laryngeal sporotrichosis, local symptomatic treatment is used, aimed at reducing unpleasant subjective sensations. Cure for laryngeal sporotrichosis depends on the effectiveness of the general treatment.
How to prevent laryngeal sporotrichosis?
Prevention of laryngeal sporotrichosis involves careful and timely treatment of damaged skin, as well as the use of respirators that can trap dust particles containing fungal spores, especially by persons engaged in agricultural work.
What is the prognosis for laryngeal sporotrichosis?
With early diagnosis and treatment, sporotrichosis of the larynx has a favorable prognosis even in the disseminated form; it is significantly worse if the mucous membrane, internal organs or bones are involved in the process.