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CASE REPORT
Laryngeal leishmaniasis in a patient taking inhaled corticosteroids
  1. Rachel Margaret Roberts1,
  2. Jayanta Mukherjee2,
  3. David Phillips3
  1. 1Department of Intensive Care Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  2. 2Department of Respiratory Medicine, Warwick Hospital, Warwick, UK
  3. 3Warwick Hospital, Warwick, UK
  1. Correspondence to Dr Rachel Margaret Roberts, rachel.cary{at}gmail.com

Summary

We present a case of a man in his late 60s, who had spent 3–4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection.

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