Pharyngeal scleroma: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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The pharyngeal scleroma is a particular manifestation of the common chronic upper respiratory tract infection, known as the "Scleroma", characterized by chronic catarrhal inflammation of the mucous membrane of the upper respiratory tract and scleral infiltrates that extend from the nasal cavity to the bronchi. The disease is characterized by endemic foci (Ukraine, Belarus, Poland, the Baltic countries).
Pathological anatomy. The pharyngeal scleroma is manifested by dense, non-ulcerative infiltrates that capture the entire thickness of the underlying tissues. Histologically, these infiltrates are hyaline degeneration with giant vacuolized Mikulich cells in which the encapsulated Frish sticks are located.
Symptoms of scleroma of the pharynx. The disease begins with catarrhal inflammation of the nasopharyngeal mucosa and the formation of crusts, which at the initial stage of the disease make the doctor suspect the presence of the lake. Infiltrates spread to all the walls of the pharynx, soft palate, palatine arch, causing the narrowing of the lumen of the pharynx. As a rule, the pharyngeal scleroma begins with a rhinoscleroma, therefore similar changes are observed in the posterior sections of the nasal cavity and in the nasopharynx. A favorite place for the appearance of scleral infiltrates is the physiological narrowing of the upper respiratory tract. The disease lasts dozens of years without ulceration and adenopathy, gradually leading to a narrowing of the pharynx and a violation of swallowing. Sclerous infiltrates produce a special liquid on their surface that dries up into grayish-white crusts, which produce a distinctly odorless sugary odor, distinct from the odor of the lake. Without treatment, the disease eventually leads to cachexia or to the occurrence of pulmonary tuberculosis.
The diagnosis is made on the basis of epidemics, a characteristic clinical picture and histological examination data, in which giant Mikulich cells are found in a biopsy. Differentiate scleroma of the pharynx from 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 magnificent scleral foci, vaccine and radiotherapy. Complete recovery is extremely rare.
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