Vocal fold cryptococcal granuloma: A rare occurrence in immunocompetent patient

• Published in: International journal of surgery case reports Vol. 115; p. 109228
• Main Authors: Zainal Abidin, Muhamamad Raziin, Syed Hamzah Al-Yahya, Syarifah Nafisah, Mansor, Masaany, Abdul Rahim, Norazila
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2024; Elsevier
• Subjects: Case Report; Immunocompetent; Laryngeal cryptococcus; Vallecular cyst; Voice Handicap Index-10; Case report; Laryngeal cryptococcus; Vallecular cyst; Immunocompetent; Voice Handicap Index-10
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109228

Cryptoccous infection or cryptococcosis is a severe opportunistic infection occurring mainly in immunocompromised patients. Laryngeal cryptococcus infection is rare. In an immunocompetent patient, inhaled corticosteroid was reported to be a possible risk factor. We discuss a case of right vocal fold cryptococcus infection in a healthy, immunocompetent 71-year-old man with no history of inhaled corticosteroid, presented with hoarseness and intermittent aspiration symptom for 1 year duration. Further examination showed right anterior vocal fold mass with presence of right vallecular cyst. Patient underwent direct laryngoscopy, excision of right vocal fold mass and marsupialization of vallecular cyst. Histopathological examination revealed cryptococcal infection. Patient subsequently treated with oral fluconazole 400 mg daily for 6 months. To date, hoarseness and aspiration symptoms have resolved. We are sharing our experience in managing laryngeal cryptococcus infection in an immunocompetent patient where the associated risk factors discussed in previous literatures are absent. •Laryngeal cryptococcus infection is rare.•It is rarer in an immunocompetent patient.•Histopathology examination reported granulation tissue with fungal body granuloma.•Fungal staining favours cryptococcus species.•Treatment with oral Fluconazole prescribed 400mg daily for 6 months.