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2021, Number 1

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Rev Cubana Med Trop 2021; 73 (1)

Oral histoplasmosis

Peraza BJ, Rosales TP, Morales FA, Pila PR, de Armas RY
Full text How to cite this article

Language: Spanish
References: 8
Page: 1-11
PDF size: 331.89 Kb.


Key words:

histoplasmosis, oral lesion, diabetes, smoker, chronic alcoholism.

ABSTRACT

Introduction: Histoplasmosis is a mycosis caused by Histoplasma capsulatum. This fungus is found in the feces of some animals (bats and birds) and its reservoir is the soil. Histoplasmosis is an endemic disease in the American continent. Inhalation of spores causes primary pulmonary infection, which may in turn be disseminated.
Objective: Describe a case of oral histoplasmosis in a patient seronegative to the human immunodeficiency virus.
Clinical case: A case is presented of a diabetic, smoker and alcoholic patient with fever of several months' evolution and respiratory manifestations. Examination revealed ulcers in the patient's gums and tongue, as well as nodular lesions in the mouth mucosa, the bottom of the vestibular sulcus and the alveolar ridge. Laboratory testing found anemia, leucopenia and an increased globular sedimentation rate. The diagnosis was confirmed by cytology and histopathology. The treatment indicated was 200 mg itraconazole three times a day and then 200 mg twice a day for two months, and a daily tablet for six months after the second month. The patient is now asymptomatic and the oral lesions have disappeared.
Conclusions: Histoplasmosis is mainly diagnosed by epidemiological testing, clinical examination and culture. Cytopathologic and histopathological analysis of the ulcer confirm the diagnosis. The case illustrates an infrequent form of presentation of the disease, not usually suspected but possible. The study is a warning to dentists, maxillofacial specialists and all the health personnel caring for patients with systemic manifestations.


REFERENCES

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  2. Azar MM, Loyd JL, Relich RF, Wheat J, Hage CA. Current Concepts in the Epidemiology, Diagnosis, and Management of Histoplasmosis Syndromes. Semin Respir Crit Care Med. 2020;41(1):13-30. Disponible en: https://10.1055/s-0039-1698429

  3. Fernández Andreu CM, Illnait Zaragozí MT, Martínez Machín G, Perurena Lancha MR, Monroy Vaca E. Una actualización acerca de histoplasmosis Rev Cubana Med Trop. 2011;63(3).

  4. Wheat LJ, Azar MM, Bahr NC, Spec A, Relich RF, Hage C. Histoplasmosis. Infect Dis Clin North Am. 2016;30(1):207-27. Disponible en: http://10.1016/j.idc.2015.10.009

  5. Azar MM, Hage CA. Clinical perspectives in the diagnosis and management of histoplasmosis. Clin Chest Med. 2017;38:403-15.

  6. Kumar A, Rattan V, Rai S, Nambiyar K. Localized Oral Histoplasmosis in an Immunocompetent Patient: A Rare Occurrence with Review of the Literature. J Maxillofac Oral Surg. 2020;19(3):355-358. Disponible en: https://10.1007/s12663-019-01273-2

  7. Saheki MN, De Oliveira A, De Matos M, Conceicao- Silva F, Wanke B, Lazera M. Histoplasmose cutánea primaria: relato de caso em paciente inmunocompetente e revisão de literatura. Rev Soc Brasileira Méd Tropical 2008;41(6):680-2.

  8. Morote S, Nacher M , Blaizot R , Ntab B, Blanchet D, Alsibai KD, et al. Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana. J Fungi (Basel). 2020;6(3):E133. Disponible en: https://10.3390/jof6030133




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Rev Cubana Med Trop. 2021;73