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PRIMARY LARYNGEAL CANDIDIASIS WITH TUBERCULOSIS MIMICKING LARYNGEAL NEOPLASM

A 50 -year-old man presented with hoarseness of voice, cough with expectoration for one month and severe dyspnoea from 15 days. C T Scan of the neck revealed soft tissue lesion circumferentially involving supra-glottic region with effacement of bilateral pyriform fossa predominantly on left side. Extralaryngeal spread to adjacent paralaryngeal space was also seen on left side. Marked airway luminal compromise was seen at the level of false vocal cord . Primary diagnosis of laryngeal malignancy was considered on findings revealed by CT scan neck. Direct laryngoscopy revealed erythema and ulcer with white pus discharge on left false vocal cord. A swab was taken from ulcer on left false vocal cord and sent for microbiological examination. The microbiological findings confirmed Mycobacterium tuberculosis with Candida albicans.. CONCLUSION: Primary candidiasis with tuberculosis in the laryngeal mucosa is a rare entity. The clinical and pathological presentations of laryngeal candidiasis and tuberculosis might be confused with those for malignant lesions if extralaryngeal spread is seen. Potential pitfalls in diagnosis and the importance of microbiological examination in rare case of dual superimposed primary laryngeal infections has been outlined.