## Overview Guttural pouch mycosis is a fungal infection (usually Aspergillus) of the guttural pouch. Fungal plaques commonly form over major arteries. Erosion of the vessel wall causes potentially fatal nosebleeds. Dysphagia and cranial-nerve deficits also occur. ## Causes Aspergillus infection. Predisposing factors are unclear. ## Diagnosis Endoscopy showing fungal plaques, often over the internal carotid or other arteries. History of epistaxis is highly suggestive. ## Treatment Occlusion of the affected artery (coil or balloon embolization) to prevent fatal hemorrhage, plus topical antifungal medication. Medical treatment alone is slow and less reliable for preventing bleeds. ## Recovery and Prognosis Guarded. Successful arterial occlusion prevents fatal hemorrhage in many cases. Neurologic deficits may persist. ## Prevention None specific.
epistaxis (can be fatal); nasal discharge; difficulty swallowing; cranial nerve deficits
## Overview Guttural pouch mycosis is a fungal infection (usually Aspergillus) of the guttural pouch. Fungal plaques commonly form over major arteries. Erosion of the vessel wall causes potentially fatal nosebleeds. Dysphagia and cranial-nerve deficits also occur. ## Causes Aspergillus infection. Predisposing factors are unclear. ## Diagnosis Endoscopy showing fungal plaques, often over the internal carotid or other arteries. History of epistaxis is highly suggestive. ## Treatment Occlusion of the affected artery (coil or balloon embolization) to prevent fatal hemorrhage, plus topical antifungal medication. Medical treatment alone is slow and less reliable for preventing bleeds. ## Recovery and Prognosis Guarded. Successful arterial occlusion prevents fatal hemorrhage in many cases. Neurologic deficits may persist. ## Prevention None specific.
epistaxis (can be fatal); nasal discharge; difficulty swallowing; cranial nerve deficits