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Clinical Note
June 1999

Left Vocal Cord Paralysis as a Primary Manifestation of Invasive Pulmonary Aspergillosis in a Nonimmunocompromised Host

Author Affiliations

From the Departments of Otolaryngology (Drs Nakahira and Saito) and Internal Medicine (Dr Miyagi), Kochi Medical School, Kochi, Japan.

Arch Otolaryngol Head Neck Surg. 1999;125(6):691-693. doi:10.1001/archotol.125.6.691

We report the first case (to our knowledge) of vocal cord paralysis as a primary manifestation of invasive pulmonary aspergillosis, which occurred in a 69-year-old woman without immunodeficiency. Her chest radiograph showed left upper lobe infiltration with pleural thickening, and a computed tomogram of her chest showed a thick pleural reaction and fibrosis around the arch of the aorta. A transbronchial biopsy specimen revealed Aspergillus infection. The patient was treated with oral itraconazole. However, since vocal cord paralysis persisted, the patient underwent type I thyroplasty to improve vocal function. A review of the literature showed that the incidence of invasive pulmonary aspergillosis has increased, even in nonimmunocompromised subjects, and that the disease has a potential for recurrent laryngeal nerve palsy. Therefore, invasive pulmonary aspergillosis should be considered in patients with vocal cord paralysis.