Case presentation A 60-year-old woman with chronic kidney disease, who had undergone a kidney transplant nine months before, was presented with progressive cough, dyspnea, and hoarseness. The patient was initially (three months before) presented with upper respiratory symptoms, for which she was prescribed with oral antibiotic therapy. But her symptoms continued to worsen, and cough became productive with white, frothy phlegm along with fever, wheezing, hoarseness, and fatigue.
History Chronic gastroesophageal reflux disease Smoking (14-packs-year) Investigations The flexible laryngotracheoscopy image showed diffuse, white-to-yellow pseudomembranous plaques lining involving the glottis and supraglottis (Image A) and posterior tracheal wall of the trachea (Image B). A supraglottic biopsy demonstrates branching organisms superficial to squamous epithelium (Image C). Diagnosis…
