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Thorax 1999;54:860-861 doi:10.1136/thx.54.9.860
  • Case Report

Laryngeal aspergillosis following high dose inhaled fluticasone therapy for asthma

  1. A J Fairfax,
  2. V David,
  3. G Douce
  1. Departments of Respiratory Medicine, Ear, Nose & Throat Surgery and Pathology, Staffordshire General Hospital, Weston Road, Stafford ST16 3SA, UK
  1. Dr A J Fairfax.
  • Received 15 September 1997
  • Revision requested 12 January 1998
  • Revised 11 February 1998
  • Accepted 2 March 1998

Abstract

The case history is presented of a 75 year old man with chronic asthma who was treated with inhaled fluticasone propionate in a daily dose of 2 mg using a Diskhaler. After three years of treatment he developed progressive hoarseness. Both vocal cords were colonised byAspergillus fumigatus which formed a white slough on the surface. Biopsy specimens showed changes suggestive of laryngeal aspergillosis with an ulcerated epithelium, fibrinopurulent debris, and colonies of fungal hyphae. A slow recovery occurred after three months of treatment with topical amphotericin and with cessation of inhaled corticosteroids. Laryngoscopy is recommended if hoarseness occurs during treatment with fluticasone.

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