Abstract

Objective: To determine the frequency and clinical forms of oral manifestations associated to Paracoccidioidomycosis (PCM) and Histoplasmosis. Material and Methods: 481 medical records of outpatients referred to the Medical Mycology Department were reviewed since 2009 to 2016. Data were analyzed using descriptive statistical methods. Results: 47 (9.77%) cases had oral manifestations, 29 (61.70%) were associated to PCM and 18 (38.29%) to histoplasmosis. For PCM, male-female ratio was 8:1 and 1:1 for histoplasmosis. The average age for PCM was 48 years old and 53 for histoplasmosis. All the PCM patients had more than 1 oral structure affected: 44.82% were gingival lesions and 27.58% palate. In patients with histoplasmosis, 6 (33.33%) were lesions affecting palate and 6 (33.33%) involving tongue. For both entities, painful ulcers and granulomatous-like lesions were the most prevalent clinical forms; however, we observed a wide range of other oral manifestations. Regarding PCM patient’s comorbidities, 3 (10.34%) cases had HIV/AIDS, 8 (27.58%) histoplasmosis and 2 (6.89%) carcinomas. Whereas the comorbidities of patients with histoplasmosis, 2 (11.11%) had HIV/AIDS and 1 (5.55%) had carcinoma. Conclusion: In endemic countries for both mycoses, dentists must be aware of patients with mouth lesions, take advantage of epidemiologic clues that suggest risk factors and be acquainted with all the current diagnostic tests in order to make a quick diagnosis and treatment in highly suspicious cases.

Highlights

  • Objective: To determine the frequency and clinical forms of oral manifestations associated to Paracoccidioidomycosis (PCM) and Histoplasmosis

  • Paracoccidioidomycosis (PCM) and Histoplasmosis are granulomatous, systemic, chronic and endemic mycoses in Venezuela; Paracoccidioides brasiliensis complex has only been reported in Latin America, whereas Histoplasma capsulatum is found in temperate areas around the world

  • We reported 1 case of oral histoplasmosis associated to a neoplasia

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Summary

Introduction

Paracoccidioidomycosis (PCM) and Histoplasmosis are granulomatous, systemic, chronic and endemic mycoses in Venezuela; Paracoccidioides brasiliensis complex has only been reported in Latin America, whereas Histoplasma capsulatum is found in temperate areas around the world. They both show oral manifestations when hematic or lymphatic dissemination occurs [1,2,3,4]. These mycoses begin when the mycelial forms are inhaled; once in the lungs, they can be disseminated causing manifestations in lymph nodes, liver, bones, nervous system and mouth, among other structures. It is important to establish a casuistry and account of these diseases as differential diagnoses in endemic areas such as Venezuela [5,6,7]

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