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Oral histoplasmosis in a patient infected with HIV. A case report
S Swindells1, T Durham, S L Johansson
1Department of Internal Medicine, University of Nebraska Medical Center, Omaha.
Abstract:
Histoplasmosis is a frequent complication of HIV infection and is usually the result of reactivation. In the immunocompromised host, histoplasmosis may cause a chronic pulmonary infection or disseminated disease. In the setting of disseminated disease, oral lesions are present in 30% to 50% of patients and may occur in almost every part of the oral mucosa. The most common sites are the tongue, palate, and buccal mucosa. In some cases, oral lesions appear to be the primary or only manifestation of disease. We have been able to find only five case reports in the literature of histoplasmosis in HIV infection with oral lesions. In two of the cases, histoplasmosis was apparently localized to the oral cavity, whereas two cases also had evidence of disseminated disease, the fifth was undetermined. We report one such case of apparently localized oral histoplasmosis in a patient with HIV infection.
Insights
Histoplasmosis is a common complication in individuals with human immunodeficiency virus (HIV) infection, often reactivating. This case report details localized oral histoplasmosis in an HIV-positive patient, highlighting a rare presentation.
Area of Science:
- Infectious Diseases
- Oral Medicine
- Immunology
Background:
- Histoplasmosis frequently complicates human immunodeficiency virus (HIV) infection, typically arising from reactivation.
- In immunocompromised individuals, histoplasmosis can manifest as chronic pulmonary or disseminated disease.
Observation:
- Oral lesions occur in 30-50% of disseminated histoplasmosis cases in HIV patients, affecting various oral mucosal sites.
- The tongue, palate, and buccal mucosa are the most commonly affected areas.
- Oral lesions can be the sole or primary indicator of histoplasmosis.
Findings:
- Literature review identified only five previous case reports of histoplasmosis with oral lesions in HIV-infected patients.
- Two prior cases showed localized oral histoplasmosis, two showed disseminated disease, and one was undetermined.
- This report presents a case of apparently localized oral histoplasmosis in an HIV-positive individual.
Implications:
- Localized oral histoplasmosis is a rare but significant manifestation in HIV patients.
- Recognition of oral lesions is crucial for early diagnosis and management of histoplasmosis in immunocompromised hosts.
- This case contributes to understanding the spectrum of oral manifestations in HIV-associated infections.