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Oropharyngolaryngeal Sarcocystosis and Histoplasmosis Co-Infection in a Patient with Systemic Lupus Erythematosus

Noppadol Larbcharoensub, Wasana Kanoksilp, Chewarat Wirojtananugoon, Maria Nina Chitasombat, Wannapong Chawengkiattikul, Kanyaprin Bhummichitra and Prawat Nitiyanant1

Sarcocystosis is an uncommon zoonotic coccidian protozoal infection caused by Sarcocystis spp. Muscular sarcocystosis have been detected in patients with various types of cancer but co-infection with histoplasmosis has never been reported. We report a 39-year-old woman with active lupus nephritis who presented with hoarseness for eleven months. Physical examination and magnetic resonance imaging revealed an irregular exophytic mass at the left oropharynx and the left true vocal cord. The histopathologic diagnosis was oropharyngolaryngeal sarcocystosis and histoplasmosis. She was treated with oral itraconazole for histoplasmosis. The authors briefly review the clinicopathologic features and pathogenesis of oropharyngolaryngeal sarcocystosis and histoplasmosis and conclude the possibility of co-infection of oropharyngolaryngeal sarcocystosis and histoplasmosis, especially in immunocompromised patient.