A Case Report of Leprosy of the Larynx

Leprosy is an ancient deforming disease caused by Mycobacterium leprae, which is still poorly understood and often feared by the general public and even by some in the health care professions. Fortunately, the outlook for patients has dramatically improved over the last three decades with the introduction of multi-drug treatment and management strategies that have somewhat diminished the stigma of this diagnosis. Here we report a case of leprosy of larynx. Case Report: A 45-year-old Afghan man who had presented with cough,dyspnea and hoarseness since many years ago was referred to our clinic due to worsening complaints. Because of the demonstration of acid fast bacilli in the smear of his sputum,diagnosis of tuberculosis was made and anti-tuberculosis treatment was initiated. However, he developed fever and his symptoms worsened,which led to his admission. On examination, there was a tender erythematous nodule in the right supraclavicular region, loss of eyebrows and eyelashes,and disseminated hyper-and-hypo pigmented cutaneous lesions on the abdomen, thorax and back. Chest x-ray was normal. In order to rule out laryngeal tuberculosis, laryngoscopy was done and granulomatous lesions were seen. Laryngeal and skin biopsy was performed. Both specimens revealed numerous acid fast bacilli, macrophages and foamy cells which were suggestive of lepromatous leprosy. Treatment was started based on multibacillary regime of WHO multidrug therapy. In conclusion, this report highlights the importance of systemic involvement in lepromatous leprosy, especially when the initial presentation is laryngitis or respiratory symptoms. Laryngeal leprosy may be mistaken with tuberculosis or laryngitis due to respiratory problems and the existence of acid fast bacilli in respiratory secretions.