Upper airway obstruction due to laryngeal coccidioidomycosis in a 5-year-old child.

Laryngeal coccidioidomycosis with severe upper airway obstruction occurred in a 5-year-old boy. Diagnosis was confirmed by positive serum precipitin and complement fixation titers, pathologic demonstration of typical Coccidioides spherules in biopsy specimens from subglottic tissue and paratracheal lymph nodes, and culture of C. immitis from the subglottic tissue specimen. The child was treated successfully with tracheostomy and intravenously administered amphotericin B (total dose of 60 mg/kg).