title: [Hoarsness after a trip to the United States of America].
abstract: A 52 year old Swiss presented with a sore throat and progressive hoarseness. The histology showed a granulomatous inflammation of the epiglottis. Microbiology revealed dimorphic fungi in the sputum which were identified as Histoplasma sp. The histoplasma antigen was positive in urine and serum. Antimycotic therapy with itraconazol p.o. was started and switched to Amphotericin B i. v. due to clinical deterioration. Adrenal insufficiency should be considered in any patient with disseminated histoplasmosis since both the infection as well as the antimycotic treatment may cause Morbus Addison. An alternative therapy for the disseminated histoplasmosis is voriconazol. The investigation of the travel history is an important point.
authors.affiliation: Innere Medizin, Ospedale Regionale di Lugano, Civico.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Nobile
authors.forename: Reto A
authors.initials: RA
authors.lastname: Schüpbach
authors.forename: Markus
authors.initials: M
authors.lastname: Flepp
authors.forename: Marco
authors.initials: M
authors.lastname: Maggiorini
authors.forename: Huldrych
authors.initials: H
authors.lastname: Günthard
authors.forename: Annelies S
authors.initials: AS
authors.lastname: Zinkernagel
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D006660:Histoplasmosis / Q000175:diagnosis* / Q000473:pathology; D006685:Hoarseness / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007820:Laryngeal Mucosa / Q000473:pathology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014195:Travel
keywords: Heiserkeit; Hoarseness; Reiseanamnese; Voriconazol; dimorphe Pilze; dimorphic fungi; granoulomatous inflammation; granulomatöse Entzündung; travelhistory