Cytomegalovirus causing necrotizing laryngitis in a renal and cardiac transplant recipient.

Abstract

Cytomegalovirus (CMV) infection is a common opportunistic pathogen in transplant recipients; however, cytomegaloviral laryngitis is extremely rare. We present a case of disseminated CMV infection and ulcerating necrotizing laryngitis situated in the subglottis of an immunocompromised patient with a renal and cardiac transplant. The patient was initially seen with discomfort in the throat. Physical examination of the head and neck, fiberoptic laryngoscopy, and CT scan of the larynx were normal. Histopathology of a laryngeal ulcer in the subglottic region showed intranuclear and intracytoplasmic bodies. Immunoperoxidase stain and in situ hybridization studies were positive for CMV. In immunosuppressed patients with persistent throat symptoms, the systematic exploration of larynx and bronchus is necessary to rule out the presence of opportunistic infections.