Laryngeal aspergillosis following high dose inhaled fluticasone therapy for asthma

Thorax. 1999 Sep;54(9):860-1. doi: 10.1136/thx.54.9.860.

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 by Aspergillus 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.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Aged
  • Androstadienes / administration & dosage
  • Androstadienes / adverse effects*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects*
  • Aspergillosis / chemically induced*
  • Aspergillosis / drug therapy
  • Aspergillus fumigatus
  • Asthma / drug therapy*
  • Fluticasone
  • Glucocorticoids
  • Humans
  • Laryngeal Diseases / chemically induced*
  • Laryngeal Diseases / drug therapy
  • Male

Substances

  • Androstadienes
  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Fluticasone