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. 1999 Sep;54(9):860–861. doi: 10.1136/thx.54.9.860

Laryngeal aspergillosis following high dose inhaled fluticasone therapy for asthma

A Fairfax 1, V David 1, G Douce 1
PMCID: PMC1745577  PMID: 10456978

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.



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