Thracheal hystoplasmosis Case report Clínica Marly Bogotá, Colombia

Histoplasmosis traqueal Reporte de un caso en la Clínica de Marly Bogotá, Colombia

Is the case of a 76 year old patient diagnosed with COPD a few years ago, having recurrent episodes in treatment with bronchodilators and steroids. The patient was sent to Clínica Marly with an 80% upper airway obstruction. The treatment initially included laser therapy and biopsies of the obstruction. The therapy was successful and the histological findings were compatible with tracheal histoplasmosis. Thoracic and abdominal CAT Scans were performed without pathological findings. A systematic research for tracheal histoplasmosis was made and there weren’t any specific articles on the subject in world literature. Upper airway histoplasmosis includes lesions in head, neck, larynx and oral cavity in that the host has any case of immunosupression and begins with disseminated disease. Upper airway histoplasmosis produces dysphonia, dyspnea and usually dysphagia. The oral mucous, tongue and larynx are the usual places of presentation of the disease in this location. Nodular disease is present in some structures
with or without neck lymph nodes. The goal of treatment is to reduce mortality and complications. B Amphotericin is the first choice drug for lung or disseminated disease or itraconazole for 3 to 6 months even there is not a consensus on the length of the treatment.
CONCLUSION: We present one of the very few case reports in world literature of pure tracheal histoplasmosis probably associated with chronic steroids use in upper airway. This is a very unusual complication that must be considered as a differential diagnosis in upper airway obstruction.