Left vocal cord paralysis as a primary manifestation of invasive pulmonaryaspergillosis in a nonimmunocompromised host

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