title: Pulsed dye laser treatment of primary cryptococcal laryngitis: A novel approach to an uncommon disease.
abstract: An 82-year-old supplemental oxygen dependent woman with severe COPD presented with an eight month history of worsening hoarseness and stridor. Office laryngoscopy revealed laryngeal edema and ulcerative masses throughout the larynx. In-office biopsies were positive for Cryptococcus neoformans. This report details a novel approach to the treatment of cryptococcal laryngitis, a combination of in-office pulsed-dye laser (PDL) ablation and medical therapy. Despite treatment with oral fluconazole, the recommended treatment for cryptococcal laryngitis the patient continued to be symptomatic with dysphonia and throat discomfort. Repeated laryngeal exam demonstrated persistent cryptococcal nodules. The patient was subsequently effectively treated with an in-office PDL laser. This case demonstrates the efficacy of in-office laser treatment for residual laryngeal Cryptococcus. For patients like this one, who have failed medical therapy and are unfit for general anesthetic, the in-office laser provides an excellent alternative treatment approach.
authors.affiliation: UCLA, Department of Head and Neck Surgery.
authors.forename: Ezinne J
authors.initials: EJ
authors.lastname: Ihenachor
authors.affiliation: UCLA, Department of Head and Neck Surgery. Electronic address: kdewan@mednet.ucla.edu.
authors.forename: Karuna
authors.initials: K
authors.lastname: Dewan
authors.affiliation: UCLA, Department of Head and Neck Surgery.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Chhetri
mesh_terms: D000369:Aged, 80 and over; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007827:Laryngitis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery*; D007828:Laryngoscopy; D053685:Laser Therapy; D054025:Lasers, Dye / Q000627:therapeutic use*