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Treating oral histoplasmosis in an immunocompetent patient

José Luis Muñante-Cárdenas1, Adriano Freitas de Assis, Sergio Olate

  • 1Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil.

Journal of the American Dental Association (1939)
|November 4, 2009
PubMed
Abstract

Insights

Oral histoplasmosis, a fungal infection, can affect immunocompetent individuals. Early diagnosis and treatment of oral lesions are crucial for effective management.

Area of Science:

  • Mycology
  • Infectious Diseases

Background:

  • Histoplasmosis is a global deep fungal infection caused by Histoplasma capsulatum.
  • Oral histoplasmosis is increasingly recognized, particularly in human immunodeficiency virus (HIV)-positive immunosuppressed patients.
  • Reports also document histoplasmosis in immunocompetent individuals, especially in endemic regions.

Observation:

  • A case study details an HIV-negative, immunocompetent 60-year-old male presenting with painful oral ulcers.
  • Differential diagnoses included squamous cell carcinoma and systemic mycosis.
  • Biopsy confirmed histoplasmosis, leading to treatment.

Findings:

  • The patient received a treatment regimen including itraconazole, nystatin, and chlorhexidine mouthwash.
  • A four-month course of itraconazole (initially 200 mg/day, then 100 mg/day) resulted in complete resolution of oral lesions.

Implications:

  • Accurate diagnosis of oral ulcerated lesions requires careful clinical evaluation.
  • Awareness of oral histoplasmosis manifestations aids earlier diagnosis and prompt treatment initiation.

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