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Scleroma of the pharynx: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Scleroma of the pharynx is a particular manifestation of a common chronic infectious disease of the upper respiratory tract, known as "Scleroma", characterized by chronic catarrhal inflammation of the mucous membrane of the upper respiratory tract and scleroma infiltrates spreading from the nasal cavity to the bronchi. The disease is characterized by endemic foci (Ukraine, Belarus, Poland, the Baltic countries).
Pathological anatomy. Scleroma of the pharynx is manifested by dense non-ulcerating infiltrates, capturing the entire thickness of the underlying tissues. Histologically, these infiltrates represent hyaline degeneration with giant vacuolated Mikulicz cells, which contain encapsulated Frisch rods.
Symptoms of pharyngeal scleroma. The disease begins with catarrhal inflammation of the mucous membrane of the nasopharynx and with the formation of crusts, which at the initial stage of the disease make the doctor suspect the presence of ozena. Infiltrates spread to all the walls of the pharynx, soft palate, palatine arches, causing a narrowing of the lumen of the pharynx. As a rule, pharyngeal scleroma begins with rhinoscleroma, therefore similar changes are observed in the posterior parts of the nasal cavity and in the nasopharynx. A favorite place for the appearance of scleroma infiltrates is physiological narrowing of the upper respiratory tract. The disease lasts for decades without ulcers and adenopathy, gradually leading to narrowing of the pharynx and swallowing disorders. Scleroma infiltrates secrete a special liquid on their surface, drying into grayish-white crusts, emitting a special, unpleasant-cloying smell, different from the smell of ozena. Without treatment, the disease eventually leads to cachexia or the development of pulmonary tuberculosis.
The diagnosis is established based on the epidemiological history, characteristic clinical picture and histological examination data, in which giant Mikulicz cells are found in the biopsy. Scleroma of the pharynx is differentiated from ozena of the pharynx, lupus and syphilis.
Treatment of pharyngeal scleroma includes the use of massive doses of streptomycin, mechanical, chemical and diathermocoagulation destruction of the most lush scleroma foci, vaccine and radiotherapy. Complete recovery occurs extremely rarely.
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