Fungus is not a normal finding on the vocal folds but can occur in a number of settings. Perhaps the most common is in the patient treated with inhaled steroids for asthma or airway inflammation. Other patients susceptible to fungus include those on antibiotics and those with immune supression. Symptoms on presentation include hoarseness and rarely discomfort.
Typical physical findings include white, cheesy exudates on the vocal cords. Underlying rednesss and inflammation of the vocal tissue often occurs. Occasionally the exudate can mimic vocal cord keratosis with dysplasia or cancer.
Treatment includes systemic antifungal medications and/or removal of the causative factor leading to the infection (antibiotics, inhaled steroids).
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