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The deep mycoses in HIV infection
C Scully1, O P de Almeida, M R Sposto
1Eastman Dental Institute and Hospital for Oral Health Care Sciences, London, UK.
Abstract:
The deep mycoses are uncommon infections, usually acquired from the inhalation or ingestion of fungal spores, sometimes from the soil in areas of endemicity, such as in the Americas and south-east Asia, or from decaying vegetable matter. They are also seen in immunocompromised persons and, increasingly, in HIV-infected persons. Respiratory involvement is frequent, with granuloma formation, and mucocutaneous involvement may be seen. Oral lesions of the deep mycoses are typically chronic but non-specific, though nodular or ulcerative appearances are common. Person-to-person transmission is rare. In HIV disease, the most common orofacial involvement of deep mycoses has been in histoplasmosis, cryptococcosis, aspergillosis and zygomycosis. Diagnosis is usually confirmed by lesional biopsy although culture may also be valuable. Treatment is with amphotericin or an azole.
Insights
Deep mycoses are uncommon fungal infections often seen in immunocompromised individuals, including those with HIV. Diagnosis involves biopsy and culture, with amphotericin or azoles as primary treatments.
Area of Science:
- Mycology
- Infectious Diseases
- Immunocompromised Host
Background:
- Deep mycoses are uncommon fungal infections acquired through spore inhalation/ingestion.
- These infections occur in endemic areas (Americas, SE Asia) or from decaying matter.
- They increasingly affect immunocompromised individuals, particularly those with HIV.
Purpose of the Study:
- To summarize the epidemiology, clinical presentation, diagnosis, and treatment of deep mycoses.
- To highlight the orofacial manifestations in HIV-infected patients.
Main Methods:
- Review of literature on deep mycoses.
- Analysis of common pathogens and their characteristics.
Main Results:
- Respiratory and mucocutaneous involvement are frequent, with granulomas.
- Oral lesions are chronic, non-specific, often nodular or ulcerative.
- Histoplasmosis, cryptococcosis, aspergillosis, and zygomycosis are common in HIV disease.
- Diagnosis relies on biopsy and culture.
- Treatment involves amphotericin or azoles.
Conclusions:
- Deep mycoses require prompt diagnosis and treatment, especially in immunocompromised patients.
- Understanding orofacial manifestations is crucial for early detection in HIV patients.