Subject(s)
Histoplasmosis , Hoarseness/parasitology , Kidney Transplantation , Cryptorchidism/parasitology , Facies , Growth Disorders/parasitology , Hand Deformities, Congenital/parasitology , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Humans , Intellectual Disability/parasitology , Kidney Transplantation/adverse effects , Larynx/microbiologySubject(s)
Communicable Diseases, Emerging , Laryngeal Diseases/diagnosis , Laryngeal Diseases/therapy , Leishmania braziliensis/isolation & purification , Leishmaniasis/diagnosis , Leishmaniasis/therapy , Tracheostomy , Animals , Antiprotozoal Agents/therapeutic use , Emergencies , Hoarseness/parasitology , Humans , Laryngeal Diseases/parasitology , Leishmaniasis/complications , Male , Meglumine/therapeutic use , Meglumine Antimoniate , Middle Aged , Nasal Obstruction/parasitology , Organometallic Compounds/therapeutic use , Psychodidae , Tracheostomy/methods , Treatment OutcomeABSTRACT
We present a case of a man in his late 60s, who had spent 3-4â months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Asthma/drug therapy , Laryngeal Diseases/parasitology , Leishmaniasis/diagnosis , Leishmaniasis/drug therapy , Phosphorylcholine/analogs & derivatives , Administration, Inhalation , Aged , Antiemetics/therapeutic use , Antiprotozoal Agents/therapeutic use , Bronchoscopy/methods , Dysphonia/drug therapy , Dysphonia/parasitology , Dysphonia/physiopathology , Hoarseness/drug therapy , Hoarseness/parasitology , Hoarseness/physiopathology , Humans , Laryngeal Diseases/drug therapy , Laryngeal Diseases/physiopathology , Leishmaniasis/physiopathology , Male , Phosphorylcholine/therapeutic use , Prochlorperazine/therapeutic use , Spain , Travel , Treatment Outcome , Vocal CordsABSTRACT
This paper presents a 73 years old male with three weeks history of intermittent hemoptysis, dysphagia, dyspnea, stridor, and suffocations sensation. By means of fibrotic bronchoscopic examination, the cause was found to be a leech in the glottis. It was removed by injection of 4 ml lidocaine 2%. Infestation into the respiratory tract by a leech may become lethal because of hypoxia and death secondary to airway obstruction. A high index of suspicion of leech infestation sould be considered in patients presenting with hemoptysis, hoarseness and respiratory distress and a history of recent contact with fresh water streams.
Subject(s)
Airway Obstruction/parasitology , Foreign Bodies/parasitology , Glottis/parasitology , Hemoptysis/parasitology , Leeches , Aged , Airway Obstruction/surgery , Animals , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Glottis/surgery , Hemoptysis/surgery , Hoarseness/parasitology , Humans , Laryngoscopy , Male , Respiratory Sounds/etiology , Treatment OutcomeABSTRACT
OBJECTIVE: We report a rare UK case of laryngeal leishmaniasis, mimicking laryngeal candidiasis, associated with long term steroid inhaler use. METHODS: Case report and review of the world literature concerning leishmaniasis. RESULTS: Laryngeal leishmaniasis is a protozoal infection which is rare in the Western world. It is becoming more common, however, with increased foreign travel. The disease can be difficult to diagnose histologically, and diagnosis is often delayed because of its rarity. It can mimic malignant laryngeal disease, and patients may therefore be subjected to significant and inappropriate treatment interventions. CONCLUSIONS: A diagnosis of leishmaniasis should be considered if initial treatment for persistent hoarseness is ineffective, particularly in a patient who is at low risk of malignancy.
Subject(s)
Hoarseness/parasitology , Leishmaniasis/complications , Anti-Asthmatic Agents/adverse effects , Antimony Sodium Gluconate/therapeutic use , Antiprotozoal Agents/therapeutic use , Candidiasis, Oral/diagnosis , Diagnosis, Differential , Humans , Laryngoscopy , Leishmaniasis/diagnosis , Leishmaniasis/drug therapy , Male , Middle Aged , Time Factors , Treatment OutcomeABSTRACT
This paper presents a case of hoarseness caused by the pharyngolaryngeal localization of a leech. This pathological lesion is extremely rare in western European countries, but is more frequent in endemic areas. Possibly lethal dyspnoea, haemoptysis or haematemesis can be the revealing symptoms. When the diagnosis is suspected simple examination under anaesthesia and removal of the leech will effect a cure.
