DISSEMINATED HISTOPLASMOSIS IN A NON-HIV PATIENT: A CASE REPORT

Abstract

Histoplasmosis is a systemic infectious disease caused by the fungus Histoplasma capsulatum, which is present in contaminated soils. Infection occurs by inhaling microconidia from the filamentous phase of the fungus, and 1 of the variations of the clinical spectrum of this disease is to affect immunocompromised patients. A female patient, 41 years old, complained of dysphagia and weight loss. Her habits were positive for alcoholism, and she was a nonsmoker, with a medical history of hepatitis B, ganglionar and pulmonary tuberculosis, and intestinal histoplasmosis 4 years ago, negative for HIV infection. Intra-oral examination showed a granulomatous ulcer in soft and hard palate transition on the right and presence of lymphadenopathy at the submandibular region bilaterally. The incisional biopsy was performed, and material was sent for polymerase chain reaction analysis of leishmaniasis, with negative result. Histopathologic examination confirmed histoplasmosis. Treatment with amphotericin B was started, and after 2 months the oral lesion regressed but gut infection persisted. Histoplasmosis is a systemic infectious disease caused by the fungus Histoplasma capsulatum, which is present in contaminated soils. Infection occurs by inhaling microconidia from the filamentous phase of the fungus, and 1 of the variations of the clinical spectrum of this disease is to affect immunocompromised patients. A female patient, 41 years old, complained of dysphagia and weight loss. Her habits were positive for alcoholism, and she was a nonsmoker, with a medical history of hepatitis B, ganglionar and pulmonary tuberculosis, and intestinal histoplasmosis 4 years ago, negative for HIV infection. Intra-oral examination showed a granulomatous ulcer in soft and hard palate transition on the right and presence of lymphadenopathy at the submandibular region bilaterally. The incisional biopsy was performed, and material was sent for polymerase chain reaction analysis of leishmaniasis, with negative result. Histopathologic examination confirmed histoplasmosis. Treatment with amphotericin B was started, and after 2 months the oral lesion regressed but gut infection persisted.