Oropharyngeal and esophageal fungal infections

Oropharyngeal and esophageal fungal infections

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Monilia albicans infections (candida) cause esophageal moniliasis. Candida albicans is present in normal flora of the oropharynx and lower gastrointestinal tract and become pathogenic in immunocompromised individual cases poor: elderly patients, diabetics, with malignancies, long-term antibiotic therapy, AIDS.
Clinically characterized by dysphagia, retrosternal pain and oropharyngeal candidiasis. The patient may complain of feeling of food stuck in throat, grata, vomiting. Fever is typical of fungal esophagitis and suggest other causes.
A presumptive diagnosis can be made on the recent installation of the symptoms of oral candidiasis and dysphagia and highlight empirical antifungal therapy can be started. If the patient does not improve in 3-7 days after treatment efctuarea an endoscopy is needed to complete diagnosis.
Fungal infections of the esophagus can lead to causative agents and Aspergillus, Histoplasma capsulatum, Blastomyces dermatides that cause aspergillosis, histoplasmosis and blastomycosis. Esophageal aspergillosis is characterized by odynophagia, dysphagia and weight loss. Histoplasmosis and blastomycosis is characterized by dysphagia for solids.
Treatment consists of antifungal susceptibility depending on fungal species-specific.
Pathogenesis and causes
Candida esophagitis is caused by fungal overcrowding of the esophagus, impaired cellular immunity, or both. Overcrowding candida stasis is usually abnormal esophageal motility of the esophagus: scleroderma or achalasia, or mechanical causes: strictures. Reduction of cell-mediated immunity occurs in immunosuppressive therapy: cytotoxic agents, corticosteroids, malignancies or AIDS. Cutanatomucoasa chronic candidiasis is a congenital immunodeficiency condidozica associating and esophagitis. Candida albicans is the most frequently encountered pathogen, but were also reported cases of candidiasis with Candida tropicalis, Candida glabrata or Candida parapsilosis.
Pathological appearance of candidiasis is varied from a few white spots on the mucous membrane candidiasis up to a dense-looking pseudomembranous with flaky skin cells and fibrin. Candida fungi live on the entire surface of our body and in certain favorable conditions overpopulate certain areas cause infections. In particular they grow in areas too hot, moist and dark. Rarely condida can become systemic in 75% of patients die.
Candidiasis associated risk factors are: -Treatment with cytotoxic anticancer Immunosuppressive treatment with corticosteroids, long time -Weakened immune system through advanced malignant solid organs but also in lymphomas and leukemias -In AIDS / HIV infection and candida can often be life-threatening systemic Extended-treatment with broad spectrum antibiotics -Diabetes therapy in organ transplantation -Esophageal lesions.