Many years ago he was diagnosed with coccidiomycosis in central California and treated. He then came to my office with shortness of breath and noisy breathing. The coccidiomycosis was growing at the back of his larynx and closing off his airway by keeping the vocal cords from coming apart and also from the mass effect of the coccidiomycosis. I biopsy him in the office and an infectious disease specialist began treating him.
He received treatment with fluconazole for one year. His breathing gradually improved, even though he could not open his vocal cords normally. His voice was normal throughout, since he was able to close them completely.