Fungal infection is currently an urgent problem in medicine. According to WHO, about 20% of the world’s population has diseases of fungal etiology. Diseases caused by fungi are called mycoses. Specialists dealing with the treatment of this pathology are mycologists, infectious disease specialists. However, a fungal infection can occur in the practice of a doctor of any specialty due to the high prevalence and steady growth in the number of diseases of mycotic etiology.
Mycotic infection: causes of development
Physicians are especially worried about severe fungal infections, which are characterized by a long chronic course, severe intoxication of the body, relapses and resistance to therapy. These include mycoses of ENT organs – ear, throat, nose.
If earlier it was believed that mycoses are diseases characteristic of countries with a tropical climate, today they can be found everywhere.
A person can get a fungal infection at any age. The disease is caused by opportunistic fungi – Candida , Geotrichum , Penicillium , Aspergillus , Mucor , etc. However, some people get sick when they encounter a fungus, while others do not. This happens because a healthy organism is able to suppress the growth and reproduction of conditionally pathogenic flora, preventing the development of the disease. With a decrease in protective forces, fungi begin to lead a parasitic lifestyle on their host, fungal diseases develop.
In the modern world, the following factors contribute to the development of mycoses:
- Increased background radiation;
- Unfavorable ecological situation;
At risk are patients with the following diseases:
- Immunodeficiency states;
- Diseases of the blood;
- Oncological diseases;
- Bronchial asthma.
Fungal diseases are more often affected by persons who receive long-term antibacterial, hormonal or immunosuppressive therapy.
Diseases of fungal etiology of ENT organs: pathogenesis
To develop the disease, the fungus needs to go through several stages:
- Get on the mucous membrane;
- Grow and reproduce.
In severe mycoses, the fungal infection spreads into the blood, and then with the blood stream can penetrate into other organs, forming secondary foci. This is how disseminated forms of fungal infection of ENT organs develop.
The clinical manifestations of a particular fungal infection depend on the location and type of pathogen. But there are symptoms that unite mycoses of ENT organs:
- The presence of a discharge on the mucous membrane – it can be crusts, plaque, liquid or thick secretions (the color and consistency of the discharge depend on the pathogen).
- Pronounced phenomena of intoxication of an organism (fever, weakness, pain in muscles).
Another characteristic sign of a fungal infection is the imperceptible onset of the disease and a long and persistent course with the presence of periodic exacerbations, the lack of effect from antimicrobial therapy.
Mycotic otitis media
Mycotic ear diseases – otomycosis – occupy a leading position in the list of fungal infections of ENT organs. The disease is characterized by the fact that fungi settle and multiply on the skin of the auricles, external auditory canals, eardrum, and in the middle ear cavity.
The most common cause of mycotic otitis media is the fungus of the genus Aspergillus . It is the most common fungus in nature. The disease caused by these pathogens is called aspergillosis.
In order for otitis media to develop fungal etiology, changes in the human body are necessary:
- Inflammatory diseases are favorable conditions for the life of a fungal infection in the ear and the development of mycotic otitis media, since the exudate released during inflammation is a good breeding ground for these microorganisms.
- Also, fungi need moisture, which rises in the external auditory canal in some diseases, for example, eczematous lesions of the ear skin.
- Another “favorable” human disease for the fungal flora is diabetes mellitus. In “diabetics” the formation of earwax is increased, and glucose is found in its composition – “food” for the growth and reproduction of fungi.
Typical complaints with fungal otitis media are:
- Discharge from the ear
- Formation of crusts, plugs;
- Itching in the ear;
- Dull pain or tenderness in the ears;
- Feeling of congestion;
- Decreased hearing.
Sinusitis of fungal etiology
Chronic sinusitis is a very common disease in the practice of an otolaryngologist. A large number of sinusitis has a bacterial etiology, but recently more attention has been paid to sinusitis of a mycotic nature, due to the increased frequency of diagnostics of this pathology.
Some authors argue that in almost half of patients suffering from chronic inflammation of the paranasal sinuses, the cause of the disease is fungal flora or fungal- bacterial associations.
Clinically, fungal sinusitis is quite difficult to differentiate from bacterial, because it does not differ in localization – most often it also affects the maxillary sinuses.
- Nasal congestion (unilateral or bilateral);
- The presence of discharge from the nose, the nature of which depends on the pathogen;
- Itching in the nasal cavity;
- Pain along the trigeminal nerve;
Fungal sinusitis is distinguished by a long, persistent course and the absence of a therapeutic effect from the use of antibiotics.
The defeat of the fungal flora of the pharyngeal mucosa is called pharyngomycosis . The causative agent of this disease is most often fungi of the genus Candida , less often Aspergillus .
Pharyngomycosis proceeds with the following symptoms:
- Unpleasant sensations in the throat: itching, burning, soreness , soreness ;
- A moderate feeling of pain, unpleasant sensations intensify when eating irritating food – spicy, salty, hot.
These changes can be accompanied by a deterioration in general well-being with a rise in temperature, weakness, etc.
When examining the patient, attention is drawn to the swelling of the pharyngeal mucosa and the presence of plaque on it. The color of the plaque depends on the type of pathogen – it can be white when infected with Candida , yellow when infected with Aspergillus .
The presence of fungal diseases is a “marker” that something is wrong in the body. A healthy person should not become a “victim” of mycotic infection.
Fungi parasitize in the body with a decrease in immune defense, the development of serious diseases (diabetes, AIDS), irrational use of antibiotics, hormonal drugs, unfavorable environmental conditions, and poor living conditions.