Histoplasmosis of the gingiva. Report of a case

A 71-year-old white man presented with a large ulcerated lesion which extended to the facial and palatal aspects of the maxillary left first and second bicuspids. A biopsy was made because the lesion appeared to be carcinomatous. It proved to be benign but it was positive for histoplasmosis. Although the patient had a 9 month history of weight loss, fatigue, frequent nausea, night sweats, respiratory symptoms, and other symptoms compatible with a diagnosis of histoplasmosis, skin tests and complement fixation tests had been consistently negative. After the diagnosis was made and the organism was cultured from the oral lesion, therapy (amphotericin B) was initiated and the patient responded favorably. Within 12 months, the symptoms regressed, the oral lesions healed, and the patient regained 25 lb.