Over the course of the year, the man’s voice grew husky and shrill and raspy, but he didn’t know why.
After examining the man, the doctors found out why: a fungus was growing in his throat.
According to the account of the man, published on Thursday (August 4) in the magazine ” JAMA Otolaryngology – head and neck surgerythe man seemed healthy when he went to a clinic in Pennsylvania that treats head and neck conditions.
A man in his 60s reported he had developed “progressive hoarseness” and shortness of breath in the past 12 months. His GP had previously treated him with inhaled corticosteroids – the standard treatment for asthma – but his symptoms did not improve.
To examine a man’s vocal folds and larynx, a hollow “vocal box” that houses the vocal folds, doctors used a high-speed imaging technique called videostroboscopy. This examination revealed “severe” swelling in the tissue lining the patient’s throat that caused the airways to narrow.
Doctors also took a tissue biopsy from the man’s larynx and confirmed that the tissue was swollen, irregular and “brittle” to the touch, meaning it was tearing easily.
Closer examination of the tissue removed revealed patches of dead cells in the larynx surrounded by clusters of immune cells, suggesting that the cells had died from intense inflammation in the throat. The study also revealed budding yeast cells that immune cells had wrapped around and began to engulf.
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The diagnostic test identified the yeast as Blastomyces dermatitidisa fungus that causes an infection called blastomycosis.
B. dermatitidis grows outdoors, usually in moist soil and decaying wood and leaves, according to the Centers for Disease Control and Prevention (CDC).
In the USA, the species is especially widespread in the areas surrounding the Ohio and Mississippi valleys, the Great Lakes, and the St. Lawrence River.
People can develop blastomycosis after inhalation B. dermatitidis the spores suspended in the air, although most people exposed to the fungus do not get sick.
A weakened immune system increases the risk of infection, and people who do get the disease usually develop symptoms within three weeks to three months after inhaling the fungus spores.
According to the CDC, sometimes the infection can spread to the lungs, skin, bones or the central nervous system, which is the brain and spinal cord.
In the case of a male, the fungus only grew in the larynx, which is quite unusual. “Laryngeal blastomycosis, first reported in 1918, is a rare extrapulmonary symptom,” his doctors noted in their case report.
Due to the significant obstruction of the airway, the man underwent surgery to place a breathing tube in the trachea and a feeding tube in the stomach. He received a long-term prescription for the antifungal drug itraconazole, and during a two-month follow-up visit, his hoarseness improved significantly and his feeding tube was removed.
After five months of observation, videostroboscopy showed that the swelling in the man’s throat had receded and that the vocal folds had regained some mobility. His breathing tube was also removed at this point.
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This article was originally published by Live Science. Read the original article here.