ORAL INVOLVEMENT IN DISSEMINATED HISTOPLASMOSIS - A CASE REPORT

Abstract

Histoplasmosis is a systemic mycosis. Oral involvement is very rare, usually present in cases of disseminated disease. A 71-year-old man complained of a painful mouth sore, with a 2-month duration. The patient reported a history of heavy tobacco consumption and alcoholism. Clinical examination revealed a large ulceration extending from the hard palate to the left alveolar ridge. Computed tomography revealed involvement of the alveolar bone, showing irregularity of the left posterior alveolar ridge. The clinical diagnosis was oral squamous cell carcinoma, and an incisional biopsy was performed. Histopathological examination showed inflammatory cells in the lamina propria and numerous, small round-shaped yeast-like bodies in the interior of vacuolated macrophages. Periodic Acid-Schiff and Grocott's methenamine silver stains disclosed positive results for round bodies, confirming the diagnosis of oral histoplamosis. The patient was hospitalized, and in a short period of time, he contracted disease-related systemic complications and died. Histoplasmosis is a systemic mycosis. Oral involvement is very rare, usually present in cases of disseminated disease. A 71-year-old man complained of a painful mouth sore, with a 2-month duration. The patient reported a history of heavy tobacco consumption and alcoholism. Clinical examination revealed a large ulceration extending from the hard palate to the left alveolar ridge. Computed tomography revealed involvement of the alveolar bone, showing irregularity of the left posterior alveolar ridge. The clinical diagnosis was oral squamous cell carcinoma, and an incisional biopsy was performed. Histopathological examination showed inflammatory cells in the lamina propria and numerous, small round-shaped yeast-like bodies in the interior of vacuolated macrophages. Periodic Acid-Schiff and Grocott's methenamine silver stains disclosed positive results for round bodies, confirming the diagnosis of oral histoplamosis. The patient was hospitalized, and in a short period of time, he contracted disease-related systemic complications and died.