Am J Otolaryngol Head Neck Surg | Volume 7, Issue 2 | Case Report | Open Access

Review and Case Report: Treatment of an Atypical Manifestation of a Laryngeal Mycobacterial Infection

Khanna S¹, Cave T², Donev K³, Lott DG^2* and Karle WE²

¹University of Pennsylvania-College of Arts and Sciences and The Wharton School Philadelphia, USA
²Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Arizona, USA
³Department of Pathology, Mayo Clinic in Arizona, USA

^*Correspondance to: David G Lott 

Abstract

Objectives: We report 1 case of an atypical laryngeal mycobacterium infection through which we analyzed 10 cases of atypical manifestations of laryngeal mycobacteria infections in the literature to discuss diagnosis and therapeutic aspect of such infections. Case Report: Mycobacterium avium Complex (MAC) infections of the larynx cause shortness of breath and stridor. Atypical mycobacterium infections of the larynx are rare, difficult to detect, and lack standardized treatment regimens. Initial treatment of patient did not succeed; thus, we aim to describe one possible treatment regimen. An 81-year-old woman presented with progressive stridor and dysphonia over the course of a year. Her medical history was significant only for osteoporosis and mild dementia, but was found to have glottic stenosis and decreased mobility of the true vocal folds bilaterally due to a posterior glottic scar band. Patient underwent direct microlaryngoscopy, tracheoscopy, biopsy, glottic balloon dilation, Potassium-Titanyl-Phosphate (KTP) laser-assisted lysis of stenosis, and Kenalog injection. Pathology reported numerous infiltrates with histiocytes containing multiple acid-fast bacilli, suggesting the presence of atypical mycobacterium and were positive for MAC. Antimicrobial therapy was initiated with azithromycin, ethambutol and rifampin. Conclusion: We present the use of laser-assisted ablation of posterior glottic stenosis, in addition to long-term antibiotic therapy, as a possible sustainable treatment for atypical mycobacterium infections of the larynx.

Keywords:

Atypical mycobacterium infection; Laryngeal disease; Larynx; Mycobacterium avium complex

Citation:

Khanna S, Cave T, Donev K, Lott DG, Karle WE. Review and Case Report: Treatment of an Atypical Manifestation of a Laryngeal Mycobacterial Infection. Am J Otolaryngol Head Neck Surg. 2024; 7(2): 1261.