Introduction:
Isolated vocal cord aspergillosis is an extremely rare clinical entity, especially in immunocompetent persons. It is usually seen as part of the systemic infections involving bronchopulmonary region in an immunocompromised patient. Differential diagnosis is important in this condition as clinical features are often simulating to the laryngeal malignancy or premalignant conditions.

Aim:
Early identification and treatment of this rare isolated fungal lesion in the vocal cords prevent spread to other parts of the larynx and outside of the larynx.

Case study:
In this case, a 35-year-old male flute player presented with primary aspergillosis of the vocal cords without affecting other parts of the airway. With the help of histopathological and microbial culture report, it was diagnosed and treated early.

Results and discussion:
Video laryngoscope confirmed pale, whitish, irregular and thickened lesions involving the bilateral vocal cords, whereas histopathological examination showed colonization by both spores and broad septate hyphae without any evidence of malignant cells. Potassium hydroxide (KOH) staining and culture in Sabouraud Dextrose Agar (SDA) revealed fungal growth with bluish green velvety and powdery surface confirmed the fungal growth of Aspergillus fumigatus.

Conclusions:
An isolated fungal infection of the larynx is a rare clinical entity and often simulates a premalignant condition or squamous cell carcinoma. Early identification and treatment of this isolated fungal lesion in the vocal cords are important to prevent spread to other parts of the larynx and outside of the larynx.