Primary aspergillosis of the larynx in a patient with Felty's syndrome

Herein we report the first case of primary aspergillosis of the larynx in a patient with Felty's syndrome. A 53-year-old man, a florist by profession, with a 12-year history of rheumatoid arthritis and on treatment with stero ids, was admitted because of hoarseness, and intermittent fever of 2 weeks' duration. On admission, physical examination and laboratory data showed, a mong other findings, splenomegalia and neutropenia. At bone marrow examinat ion, normal cellularity with mild dyserythropoiesis was observed A fiberopt ic laryngoscopy showed white plaques on both the true vocal cords. Both cul ture and microscopic examination of these lesions provided the diagnosis of invasive process by Aspergillus flavus. A computed tomography of the middl e ears, paranasal sinuses, and chest was normal. Thus primary aspergillosis of the larynx and Felty's syndrome was diagnosed, and the patient was succ essfully treated with granulocyte colony-stimulating factor and systemic an tifungal agents. Felty's syndrome corticosteroid use, and occupational risk probably rendered our patient susceptible to Aspergillus infection.