Croup is a common presentation in pediatric emergency settings, most often caused by viral infections. However, when influenza A virus co-occurs with Pseudomonas aeruginosa infection, it can lead to rare and lethal complications. We report a case of a 13-month-old boy who presented with fever and croup. The patient developed suffocation after 4.5 h of hoarseness and respiratory distress, with poor response to glucocorticoids therapy. Despite mechanical ventilation, respiratory failure persisted. Serial chest radiographs over a 7-h period revealed rapid progression to complete left lung atelectasis. Bronchoscopy identified complete obstruction of the left main bronchus by a purulent mucus plug, which was removed resulting in lung re-expansion. Etiological analysis confirmed co-infection with influenza A virus (H3N2) and Pseudomonas aeruginosa. The patient was treated with sensitive antibiotics and peramivir, and was discharged on day 9 with no recurrence of symptoms.

The printing industry involves continuous exposure to volatile organic compounds (VOCs), potentially leading to pulmonary impairments. This study aimed to evaluate long-term pulmonary impairments among printing workers over a five-year period. A five-year retrospective cohort study (2020-2024) was conducted involving 87 operational printing workers (exposed group) and 86 administrative staff members (unexposed group). Occupational exposure to VOCs (benzene, toluene, ethylbenzene, xylene, isopropyl alcohol, ethyl acetate, ethanol) was assessed using NIOSH-based air sampling and GC-FID analysis. Pulmonary function was measured annually using standardized spirometry according to American Thoracic Society (ATS) guidelines. Respiratory symptoms were evaluated with the ATS questionnaire. Groups were comparable in demographics except working hours (p < 0.05). A significant upward trend in VOCs concentrations-particularly toluene, xylene, and isopropanol-was observed throughout the follow-up period (p < 0.05). Exposed workers showed declines in FEV1, FVC, PEF, and FEF (p < 0.001), with lower values than controls in 2024 (p < 0.001, except FEV1/FVC p = 0.059). Respiratory symptoms-including dyspnea, cough, wheezing, sputum production, and hoarseness-were reported significantly more frequently among exposed workers (p < 0.05). Long-term occupational exposure to VOCs in the printing industry is associated with progressive decline of pulmonary function and an increased prevalence of respiratory symptoms, even at concentrations below established occupational exposure limits. These findings underscore the need for continuous monitoring of air pollutants, regular spirometry screening, improved ventilation, substitution of hazardous solvents, and stricter adherence to protective measures within the printing industry.

Substernal goiter consists of thyroid tissue extending into the thoracic cavity and is more common in females. Total thyroidectomy is standard, though some cases require advanced approaches. Cardiopulmonary bypass (CPB) may be considered in selected cases for hemodynamic stability. We aimed to describe a rare case of retrotracheal thyroid goiter managed using CPB and review reported surgical approaches. A 39-year-old male presented with hoarseness and palpitations due to a left-sided retrotracheal thyroid goiter. Initial cervical access was unsuccessful, requiring median sternotomy with CPB for safe resection. Histopathology confirmed a benign follicular nodule, and the postoperative course was uneventful. CPB can be a valuable adjunct in complex retrotracheal substernal goiters, highlighting the importance of individualized surgical planning and a multidisciplinary approach.

Fungal laryngitis is an uncommon clinical entity that may radiographically and symptomatically mimic laryngeal malignancy, posing diagnostic challenges. We present the case of a 62-year-old male with a 40-pack-year smoking history, inhaled corticosteroid use, hypertension, diabetes mellitus, hepatitis C, and substance and alcohol abuse who presented with progressive hoarseness, sore throat, and dyspnea. Computed tomography (CT) revealed a laryngeal mass causing supraglottic airway narrowing, initially suggestive of carcinoma. Fiberoptic laryngoscopy demonstrated extensive white patches of the oropharynx, hypopharynx, and larynx. The patient showed significant clinical improvement following intravenous fluconazole and steroid therapy. Subsequent microsuspension laryngoscopy with biopsy revealed acute/chronic mucositis with reactive epithelial changes but no malignancy. Special stains (Periodic acid-Schiff (PAS), Grocott's Methenamine Silver (GMS), and Acid-Fast Bacilli (AFB)) were negative for fungi, though prior antifungal response supported the diagnosis. This case underscores the importance of considering isolated fungal laryngitis in high-risk patients with laryngeal masses to avoid misdiagnosis and unnecessary interventions.

Riedel's thyroiditis is an extremely rare fibrosing inflammatory disorder that extends beyond the thyroid capsule into surrounding structures. The disease usually progresses slowly; however, we report an unusual case with rapid progression that closely mimicked malignancy.An Asian woman in her 50s developed throat discomfort, hoarseness and a neck mass within 1 month. Laryngoscopy revealed left vocal cord paresis. Ultrasonography demonstrated a rapidly enlarging hypoechoic mass and fine-needle aspiration cytology suggested possible malignancy. Total thyroidectomy with lymph node dissection was, therefore, performed. Histopathological examination revealed dense fibrosis and obliterative phlebitis, consistent with Riedel's thyroiditis. The patient's hoarseness improved postoperatively, and she remains well 2.5 years later on levothyroxine monotherapy.This case illustrates that Riedel's thyroiditis can rarely present with acute progression and recurrent laryngeal nerve palsy, closely mimicking thyroid cancer. Early surgical intervention provided both a definitive diagnosis and effective treatment.

A 53-year-old HIV-positive man presented with progressive dyspnea, hoarseness, and near-complete tracheal obstruction. Computed tomography and rigid bronchoscopy identified a > 90% obstructing tracheal mass. Histopathology with immunohistochemistry confirmed extramedullary plasmacytoma. Bronchoscopic debulking relieved symptoms, and radiotherapy was planned.

Neurofibroma is a benign tumor arising from neural crest-derived cells and is characterized by a nonencapsulated growth pattern that incorporates surrounding nerve fibers. Laryngeal involvement is rare, and arytenoid cartilage localization is exceptionally uncommon. We present a 46-year-old woman with hoarseness and cough in whom flexible laryngoscopy demonstrated mucosal swelling over the right arytenoid cartilage. Magnetic resonance imaging revealed a 15 × 10 mm lesion that was isointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, with no diffusion restriction and heterogeneous contrast enhancement. Histopathological examination confirmed the diagnosis of neurofibroma. The lesion was completely excised using a CO2 laser under microlaryngoscopic guidance. The patient's symptoms resolved postoperatively, and no recurrence was observed during follow-up. Although laryngeal neurofibromas lack specific radiological features, magnetic resonance imaging plays a key role in evaluating lesion extent and in supporting the differential diagnosis, particularly by demonstrating the absence of diffusion restriction. To the best of our knowledge, this is the first reported case of an arytenoid cartilage neurofibroma with subglottic extension. Histopathological evaluation remains essential for definitive diagnosis, whereas minimally invasive CO2 laser excision represents an effective treatment option for small and localized lesions.