Pharyngitis is an inflammatory process that affects the lining of the throat. In the event that this disease is caused by various representatives of the fungal flora, they speak of pharyngomycosis . At the moment, this pathological process occurs quite often. At the same time, both adults and children are at risk. The clinical picture with pharyngomycosis is mainly represented by local inflammatory signs, including soreness when swallowing, a feeling of perspiration and burning in the throat, discomfort, and so on. With late seeking medical help, such a pathology can acquire a chronic course, which is an unfavorable moment in terms of prognosis. In advanced cases, pharyngomycosis can cause a pharyngeal or paratonsillar abscess, and in the most unfavorable scenario, even fungal sepsis.
As we said, the prevalence of pharyngitis caused by fungal flora has increased significantly in recent years . According to various sources, among all inflammatory processes from the pharynx, it accounts for thirty to forty percent. Often this disease is diagnosed in childhood. It is interesting that both in adulthood and in children, this pathological process is quite often combined with fungal infection of the gums, tongue, and so on. It is worth noting that pharyngomycosis is characterized by a more severe course than inflammation of the pharynx, which has a different nature.
The development of this disease is based on the effect on the mucous membrane of the pharynx of various representatives of the fungal flora. In the vast majority of cases, the causative agents are yeast-like fungi belonging to the genus Candida . In about five percent of cases, the inflammatory process is caused by molds such as aspergillus.
The most important condition for the onset of fungal pharyngitis is a reduced level of immune defense. It is most often encountered by people suffering from HIV infection or tuberculosis. However, sometimes less significant factors can provoke a fungal infection of the pharynx, for example, endocrine disorders, frequent respiratory infections, prolonged use of antibacterial drugs or glucocorticosteroids . It is noticed that the incidence rate among people using removable dentures is slightly higher.
We should also talk about HIV-infected people separately. As we have already said, among them, pharyngitis, which is of a fungal nature, is most common. This moment is easily explained by the fact that as a result of pronounced immunodeficiency, the body cannot prevent the active reproduction of fungi. Often, in patients with HIV infection, fungal foci are found in other internal organs. Statistics show that approximately ten percent of people with such a diagnosis subsequently die from the generalization of a fungal infection.
The classification of this disease includes four of its main variants, which differ on the basis of concomitant morphological changes: pseudomembranous, hyperplastic, erosive-ulcerative and catarrhal. The mildest course is observed with a catarrhal variant. During the examination, redness and smoothness of the pharyngeal mucosa can be detected. With the pseudomembranous variant, whitish or yellowish foci of plaque are revealed. It is noteworthy that this plaque can be easily removed from the underlying tissues. Hyperplastic pharyngitis implies the appearance of dense white plaques that are difficult to separate from the underlying epithelium. The erosive-ulcerative variant is established when erosions and ulcers are found on the mucous membrane, which are predominantly superficial.
Symptoms characteristic of pharyngomycosis
In general, pharyngomycosis does not have any specific clinical manifestations. First of all, it is worth noting that it can be acute and chronic. The acute form is accompanied by much more striking symptoms. With late seeking medical help or inappropriate treatment, it usually becomes chronic. In the chronic form, frequent exacerbations are observed (up to ten or more times per year). It is she who most often leads to various complications.
Initially, symptoms such as a burning sensation and a sore throat are found. The patient complains of soreness during swallowing, especially when eating irritating food. Moreover, in normal cases, the pain syndrome has a moderate degree of severity. Often, the clinical picture is complemented by an increase and soreness of the cervical lymph nodes, subfebrile fever, and general malaise.
In the event that the inflammatory process was caused by yeast-like fungi, the examination reveals symptoms such as swelling and redness of the mucous membrane, as well as whitish cheesy plaques on it. When these plaques are removed, hyperemic foci or areas of ulceration are found under them.
Diagnosis and treatment of the disease
Initially, this disease can be suspected on the basis of concomitant clinical manifestations in conjunction with a general examination. Additionally, pharyngoscopy is shown, which will reveal signs of an inflammatory process, and a smear from the pharynx followed by its microscopic and cultural examination.
Treatment for fungal pharyngitis begins with antimycotic drugs, which are prescribed for one to two weeks. The choice of antimycotic agents will depend on the nature of the pathogen. Studies show that fluconazole is most effective in the inflammatory process caused by yeast-like fungi . Local therapy is reduced to antiseptic treatment of the posterior pharyngeal wall and tonsils.