From the Guidelines
Fungal pharyngitis with associated swelling is most commonly caused by Candida species, particularly C. albicans, and is often associated with immunosuppression, diabetes, leukemia, and other malignancies, as well as steroid use, radiation therapy, antimicrobial therapy, and denture use 1. The causes of fungal pharyngitis can be attributed to various factors, including:
- Immunocompromised states, such as HIV infection, especially in patients with CD4 counts <200 cells/μL 1
- Diabetes and other metabolic disorders
- Leukemia and other malignancies
- Steroid use and radiation therapy
- Antimicrobial therapy and denture use
- Poor oral hygiene and uncontrolled diabetes
It is essential to note that the occurrence of oropharyngeal candidiasis is recognized as an indicator of immune dysfunction 1. The most effective treatment for fungal pharyngitis typically involves antifungal medications, such as fluconazole or itraconazole, and maintaining good oral hygiene 1. In cases of fluconazole-refractory infections, alternative treatments like itraconazole solution, posaconazole suspension, or voriconazole may be effective 1. Additionally, decreasing rates of oral carriage of Candida species and a reduced frequency of symptomatic oropharyngeal candidiasis are seen among HIV-infected patients on effective antiretroviral therapy 1. Therefore, antiretroviral therapy should be used whenever possible for HIV-infected patients with oropharyngeal or esophageal candidiasis.