title: Left vocal cord paralysis as a primary manifestation of invasive pulmonary aspergillosis in a nonimmunocompromised host.
abstract: We report the first case (to our knowledge) of vocal cord paralysis as a primary manifestation of invasive pulmonary aspergillosis, which occurred in a 69-year-old woman without immunodeficiency. Her chest radiograph showed left upper lobe infiltration with pleural thickening, and a computed tomogram of her chest showed a thick pleural reaction and fibrosis around the arch of the aorta. A transbronchial biopsy specimen revealed Aspergillus infection. The patient was treated with oral itraconazole. However, since vocal cord paralysis persisted, the patient underwent type I thyroplasty to improve vocal function. A review of the literature showed that the incidence of invasive pulmonary aspergillosis has increased, even in nonimmunocompromised subjects, and that the disease has a potential for recurrent laryngeal nerve palsy. Therefore, invasive pulmonary aspergillosis should be considered in patients with vocal cord paralysis.
authors.affiliation: Department of Otolaryngology, Kochi Medical School, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nakahira
authors.forename: H
authors.initials: H
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Miyagi
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage; D001228:Aspergillosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000008:administration & dosage; D008172:Lung Diseases, Fungal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013957:Thyroid Cartilage / Q000601:surgery; D013997:Time Factors; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000601:surgery
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole