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Updated: Jun 30, 2026
09:57
Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens
Published on: February 14, 2011
Oral histoplasmosis: an unusual presentation.
Nagamani Narayana1, Ryan Gifford, Peter Giannini
1Department of Oral Biology, UNMC College of Dentistry, 40th and Holdrege streets, Lincoln, Nebraska 68583, USA. nnarayana@unmc.edu
Head & Neck
|September 18, 2008
Summary
This case study reports the first instance of oral histoplasmosis in a patient using infliximab, a TNF-alpha antagonist. Treatment with itraconazole was successful, highlighting a rare complication of immunosuppressive therapy.
Area of Science:
- Mycology
- Immunology
- Gastroenterology
Background:
- Histoplasmosis is a fungal infection that can reactivate in immunosuppressed individuals.
- Tumor necrosis factor alpha (TNF-alpha) antagonists, used for autoimmune conditions, are associated with histoplasmosis reactivation.
- Granuloma formation is often suppressed in TNF-alpha antagonist-associated histoplasmosis.
Observation:
- A 75-year-old woman on infliximab presented with an unusual oral histoplasmosis.
- Microscopic examination revealed cellular atypia, prompting a lymphoma work-up.
- Gomori's methenamine silver stain confirmed Histoplasma capsulatum.
Findings:
- The patient was diagnosed with oral histoplasmosis.
- The condition was successfully treated with itraconazole.
- This represents the first reported case of oral histoplasmosis in an infliximab patient.
Implications:
- Highlights a rare oral manifestation of histoplasmosis in patients on TNF-alpha antagonists.
- Underscores the importance of considering opportunistic infections in immunosuppressed patients.
- Suggests careful monitoring for atypical presentations in patients receiving TNF-alpha inhibitors.
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