Relapsing polychondritis initially presenting with hoarseness and difficulty breathing in a 21-year-old male

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To present a case of relapsing polychondritis initially presenting with hoarseness and difficulty breathing and to discuss the diagnostic criteria and typical CT scan findings of relapsing polychondritis. <br /><strong>METHODS:</strong> <br /><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Private Hospital in Metro Manila<br /><strong>Patient:</strong> One<br /><strong>RESULT:</strong> A 21-year-old man who was initially managed as a case of bronchial asthma for persistent hoarseness and recurrent difficulty breathing was found to have severe laryngeal edema on endoscopy, and soft tissue expansion of the cricoid cartilage with calcifications and irregular first tracheal ring on CT scan. He also had recurrent eye redness and developed bilateral aural inflammation, and was subsequently diagnosed to have relapsing polychondritis.<br /><strong>CONCLUSION:</strong> Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation and eventual destruction of cartilage throughout the body. Typical manifestations may not always be present, causing a delay in diagnosis. It should be considered in patients with intractable respiratory symptoms not responsive to treatment for upper respiratory tract infections or asthma. A CT scan may reveal signs of cartilage destruction and help in diagnosis.                  </p>

Primary laryngeal aspergillosis in a postpartum patient

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To present a rare case of primary laryngeal aspergillosis manifesting with hoarseness in a seemingly healthy, immunocompetent, postpartum patient and discuss the probable contributing factors leading to this unusual disease process.</p> <p style="text-align: justify;"><strong>METHODS</strong><br /><strong>Design:</strong> Case Report<br /><br /><strong>Setting:</strong> Tertiary Private University Hospital<br /><br /><strong>Subjects:</strong>  One<br /><br /><strong>RESULTS:</strong> A 28-year-old previously healthy postpartum woman presented with hoarseness of a few weeks duration and recent intake of antibiotics and steroids. Videolaryngoscopy revealed a creamy, exophytic mass overlying both vocal folds. Microscopic examination revealed septated, dichotomously branching hyphae with acute angles characteristic of Aspergillus sp. The patient recovered with anti fungal medications.<br /><br /><strong>CONCLUSION:</strong> The clinical presentation of laryngeal aspergillosis can be very non-specific and should not be disregarded merely on the basis of immune competence. It should be considered, together with other host and environmental factors when a patient responds poorly to conventional treatment. There is a need for quick and accurate diagnosis as the disease responds quite rapidly with appropriate anti fungal medications.</p>