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Laryngeal aspergillosis. A case treated with itraconazole.
Zylberberg L; Havard S; Gorin I; Lacau St Guily J; Benoudiba D; Escande
November 30, 1993
Int Conf AIDS. 1993 Jun 6-11;9(1):368 (abstract no. PO-B09-1396). Unique

Our patient is followed since 1985 for his HIV seropositivity and has already experienced Kaposi's sarcoma. Pneumocystis pneumonia, diarrhea with Cryptosporidiosis and CMV retinitis. Antiretroviral therapy has been prescribed with ZVD followed by DDI from January 1990 to February 1992. His CD4 cells count was 10/mm3 and he also had neutropenia (600/mm3). The respiratory functional tests and the chest ct scan showed a moderate sequellar fibrosis. In October 1992 he complained of dysphonia then aphonia. A direct laryngoscopy showed thickened vocal cords covered with pseudomembranes. The direct examination of the mycology specimen showed numerous filamentous fungii that later were identified as Aspergillus fumigatus on cultures. A. fumigatus was also identified in a maxillary sinus, in the broncho-alveolar lavage specimen and in the bronchi wall of a biopsy specimen. Itraconazole has been prescribed (400 mg/day) and after a month he recovered his normal voice and the pseudo-membranes were not detected by direct laryngoscopy. Sinus and pulmonary aspergillosis are commonl reported on AIDS patients but, to our knowledge, our patient is the first one with laryngeal aspergillosis. Itraconazole seems a new potential treatment.

*Antifungal Agents/THERAPEUTIC USE *Aspergillosis/DRUG THERAPY *AIDS-Related Opportunistic Infections/DRUG THERAPY *Ketoconazole/ANALOGS & DERIVATIVES *Laryngeal Diseases/DRUG THERAPY