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Isolation, Characterization and Functional Examination of the Gingival Immune Cell Network
Published on: February 16, 2016
Oral histoplasmosis masquerading as acute necrotizing ulcerative gingivitis: A rare case report
Shaleen Khetarpal1, Trishna Mhapsekar2, Rahul Nagar3
1Department of Periodontology, Government College of Dentistry, Indore, Madhya Pradesh, India.
Abstract:
Histoplasmosis also called as "Darling's Disease" is a community-acquired primary pulmonary disease caused by inhalation of dust containing spores of soil-dwelling dimorphic fungi, Histoplasma capsulatum. Presentation of fungi in the oral cavity is usually rare and is generally associated with an immunocompromised state. Here, we present a rare case of histoplasmosis in an immunocompetent patient, with discrete oral presentation, that initially mimicked acute necrotizing ulcerative gingivitis. Gingival biopsy confirmed the diagnosis of histoplasmosis, which responded favorably to the initial treatment with intravenous amphotericin and later to oral itraconazole. Thus, a vigilant approach is paramount in reducing the fatality due to disease.
Insights
Histoplasmosis, a fungal lung infection, rarely presents in the mouth, especially in immunocompetent individuals. This case highlights oral histoplasmosis mimicking gingivitis, emphasizing early diagnosis for effective treatment.
Area of Science:
- Infectious Diseases
- Mycology
- Oral Medicine
Background:
- Histoplasmosis is a community-acquired pulmonary infection caused by *Histoplasma capsulatum*.
- Oral manifestations are uncommon and typically occur in immunocompromised patients.
- This study focuses on a rare oral presentation in an immunocompetent host.
Observation:
- A case of histoplasmosis presented with oral lesions mimicking acute necrotizing ulcerative gingivitis.
- The patient was immunocompetent, making the oral presentation unusual.
- Gingival biopsy was crucial for definitive diagnosis.
Findings:
- Histoplasmosis was confirmed via gingival biopsy in an immunocompetent patient.
- The oral lesions responded well to treatment with intravenous amphotericin B followed by oral itraconazole.
- This case underscores the importance of considering histoplasmosis in oral differential diagnoses.
Implications:
- Vigilant clinical suspicion is essential for early diagnosis of oral histoplasmosis.
- Prompt and appropriate treatment can significantly reduce morbidity and mortality.
- This case expands the understanding of histoplasmosis presentations in immunocompetent individuals.
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