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Disseminated histoplasmosis presenting as multiple oral ulcers
Nicholas Hendren1, Christina Yek1, Jason Mull1
1Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
BMJ Case Reports
|July 16, 2017
Summary
Disseminated histoplasmosis can manifest as oral ulcers in immunocompromised patients. Biopsy and fungal cultures are crucial for diagnosing this Histoplasma capsulatum infection, treatable with antifungals.
Area of Science:
- Infectious Diseases
- Mycology
- Oral Medicine
Background:
- Advanced HIV and chronic hepatitis B increase susceptibility to opportunistic infections.
- Oral ulcers can be a presenting symptom of systemic fungal infections.
Observation:
- A 61-year-old female with HIV and hepatitis B presented with an 8-week history of painful oral ulcers.
- Examination revealed multiple clean-based ulcers on the tongue and hard palate.
Findings:
- Biopsy showed intracellular yeast forms consistent with Histoplasma capsulatum var. capsulatum.
- Fungal blood cultures confirmed disseminated histoplasmosis.
- Treatment with amphotericin B followed by itraconazole led to complete resolution of ulcers.
Implications:
- Oral ulcers can be a critical sign of disseminated histoplasmosis in immunocompromised individuals.
- Histopathological examination of oral lesions is vital for diagnosing systemic fungal infections.
- Prompt diagnosis and antifungal therapy are essential for managing disseminated histoplasmosis.
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