Abstract
Introduction: Histoplasmosis is a fungal infection caused by the agent Histoplasma capsulatum,a dimorphic fungus. The spectrum of illness ranges from subclinical infection to progressive disseminated disease. The major bulk of histoplasma infections are asymptomatic or pulmonary histoplasmosis. In immune compromised patients it can cause disseminated infections involving different organs of the body. In immune competent individuals it may cause isolated adrenal histoplasmosis.
 Material and methods: A retrospective study was done to look for mucocutaneous histoplasmosis. The excised tissue samples were cultured and only culture confirmed cases were included in the study.
 Result: Here, we present five cases of primary mucocutaneous histoplasmosis in immune competent individuals in a tertiary care centre in India. These patients had no other co-morbidities and had only isolated lesions in oral cavity or penis.The tissue on excision was cultured and showed growth of Histoplasma capsulatum. All the patients improved with treatment. There are limited cases of mucocutaneous ulcerated lesions caused by Histoplasma capsulatum in immune competent people in published literature.
 Conclusion: This study emphasizes the necessity of a vigilant look out and clinical suspicion of fungal causes like histoplasma in chronic non healing ulcers which should be confirmed by the laboratory investigations. Accurate diagnosis helps in specific management of these cases.
 Bangladesh Journal of Medical Science Vol.19(1) 2020 p.94-97
Highlights
Histoplasmosis is a fungal infection caused by the agent Histoplasma capsulatum, a dimorphic fungus
A retrospective study was done in a tertiary care hospital in Eastern India which revealed five cases of primary mucocutaneous histoplasmosis during the period of five and half years (2011 – 2016)
Though cutaneous and mucocutaneous histoplasma infections are more commonly associated with HIV infected patients, it may cause disease in immunocompetent people as well as shown by Vermaet al in 2011 where the immunocompetent patient presented with rhinosinusitis and a nonhealing oral ulcer[10]
Summary
Histoplasmosis is a fungal disease caused by dimorphic fungi Histoplasma capsulatum. Two varieties of fungi are known to infect humans, namely: H. capsulatum var. capsulatum and H. capsulatum var. Results A retrospective study was done in a tertiary care hospital in Eastern India which revealed five cases of primary mucocutaneous histoplasmosis during the period of five and half years (2011 – 2016). The lesion was excised and sent for microscopy and culture On direct microscopy, it showed yeast cells on Gram stain preparation and potassium hydroxide preparation. It showed yeast cells on Gram stain preparation and potassium hydroxide preparation It was inoculated on Sabouraud’s dextrose agar and brain heart infusion agar and incubated at 370C and 250C temperature. On microscopy septate hyaline hyphae with tuberculate macroconidia and small smooth microconidia, corresponding to the structure of Histoplasma capsulatum was seen (fig 2) None of these five cases had any malignant change on histopathology.
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