口腔・食道感染症の病態と画像診断

Pathophysiology and Imaging Diagnosis of Common Infectious Diseases in Regions of Pharynx or Esophagus

要旨●口腔・食道感染症は真菌ではカンジダ，ウイルスではサイトメガロウイルス（CMV）と単純ヘルペスウイルス（HSV），細菌では梅毒などが知られている．それぞれの内視鏡所見は多彩な形態を呈し，時に同時に発症する．いずれもHIV感染症や悪性腫瘍，免疫抑制薬使用中など，易感染性状態を背景に発症する症例が多く，治療介入が遅れることで重篤化する症例もみられる．確定診断は主に生検病理組織学的検査で行われるが，早期の治療介入のためには背景の臨床像を踏まえ，注意深い観察に基づく内視鏡所見から疾患を予測することが重要である．

　Infectious diseases frequently affecting the pharyngeal and esophageal regions include fungal infections, such as those caused by Candida spp. ; viral infections, including cytomegalovirus（CMV）and herpes simplex virus ; and bacterial infections, such as those caused by Treponema pallidum. These infections are often observed in immunocompromised individuals, including those with HIV infection, malignancies, or those receiving immunosuppressive therapy. In some cases, delayed therapeutic intervention can result in fatal outcomes. Endoscopic findings in these infections vary significantly and can be further complicated by concurrent infections. Although diagnosis is primarily established through biopsy analysis, careful endoscopic evaluation considering the patient's underlying conditions is crucial for early intervention and improved prognosis.