Oral Lesions - Leading Diagnosis of Disseminated Histoplasmosis.
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Date
2016-10
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Abstract
Histoplasmosis is a systemic mycotic infection caused by Histoplasma capsulatum. Although rare in India, it is endemic in over 300 countries.
If immunity is good in a healthy person, even if this fungus is inhaled, it may cause mild symptoms and can be controlled by supportive therapy.
However, in persons with very low immunity, as in the case of human immunodeficiency virus-positive persons, a serious disseminated form
could be life-threatening in delayed diagnosis and delay in proper treatment. Due to pulmonary symptoms, it is commonly misinterpreted as
tuberculosis and treated accordingly without results. However, oral lesions which occur can reveal the correct diagnosis by biopsy procedure
and microscopic confirmation of this rare disease. We had a 76-year-old patient suffering from pulmonary signs of cough, weakness, and
with gums and tongue lesions, who was referred by a general dental practitioner for diagnosis of oral lesions. The tongue and gums lesions
biopsy revealed the correct diagnosis of granulomatous lesion with yeast-like organisms of giant cells, indicating histoplasmosis capsulatum
diagnosis which was later treated by immunology experts in the hospital with proper antifungal agents like amphetericin B and management
of this disseminated histoplasmosis with other investigations. Therefore, systemic diseases also need oral examination to rule out many
unusual diseases.
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Keywords
Disseminated form, Histoplasma capsulatum, Human immunodeficiency virus, Tuberculosis
Citation
Bhoweer Anilkumar L, Ranpise Sudarshan G. Oral Lesions - Leading Diagnosis of Disseminated Histoplasmosis. IJSS Case Reports & Reviews. 2016 Oct; 3(5): 4-8.