Abstract
Histoplasmosis, an infection caused by the dimorphic fungus, Histoplasma capsulatum, causes chronic granulomatous disease. A 63-year-old man presented with a 1-month history of a painful lesion in the gingiva, with progressive growth. Intra-oral examination revealed a solitary ulcerated lesion on the right lower alveolar ridge, with a granulomatous central area. The patient had undergone treatment for undifferentiated carcinoma in the amygdala for 3 years and pneumonia 3 months prior. The diagnostic hypotheses were squamous cell carcinoma and infectious diseases. Incisional biopsy, followed by histopathological examination, revealed chronic granulomatous inflammatory reaction with fungal elements suggestive of histoplasmosis. Grocott reaction was positive and B.A.A.R negative. Chest radiograph was unremarkable. The final diagnosis was histoplasmosis. The patient returned, 15 days after the biopsy, with new ulcers on the upper left alveolar ridge and palate. He was referred to the infectious medicine unit for treatment and continues to be followed-up by the oral medicine group.
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