Histoplasmosis masquerading as solitary oral ulcer: An unusual case report

Diwakar, N; Krishna, Sree; Jaishankar, H. P.

doi:10.15713/ins.ijmdcr.27

Cited by 2 publications

(6 citation statements)

References 9 publications

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“…The clinical manifestation of histoplasmosis is determined by the degree of exposure to infective propagules and by the host's immune status (Diwakar et al 2015). These manifestations range from asymptomatic, acute pulmonary, and chronic pulmonary infections to more widespread disseminated infections (Folk and Nelson 2017) (Figure 2).…”

Section: Clinical Presentation Of Histoplasmosismentioning

confidence: 99%

“…Approximately 30-50% of patients with subacute disseminated histoplasmosis show oral lesions and in certain cases, oral lesions appear to be the primary diagnostic manifestation of the disseminated disease (Bhagwat et al 2009, Pincelli et al 2019. The appearance of mucosal lesions due to histoplasmosis can range from verrucose, nodular, plaquelike, or ulcerative lesions, and they can appear anywhere in the mouth (Diwakar et al 2015). Two of the patients with features of dissemination presented with non-healing oral ulcers along with systemic features (Dhammika et al 2017, Jayawardena et al 2019.…”

Section: Clinical Presentation Of Histoplasmosismentioning

confidence: 99%

“…Histoplasma antibody tests are most suitable for the diagnosis of subacute and chronic forms of histoplasmosis (Azar and Hage 2017). Three types of serological assays, EIA, immuno-diffusion (ID), or complement fixation methods (CF) are used in Histoplasma antibody detection (Diwakar et al 2015). The EIA method is the most sensitive method among the three methods and the sensitivity of CF is better than the ID method (Azar and Hage 2017).…”

Section: Figure 3 Macroscopic (A) and Microscopic (40x) (B) Views Of ...mentioning

confidence: 99%

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Histoplasmosis in Sri Lanka – barely recognized, yet present

Sigera¹,

Jayasekera²,

Denning³

2023

MycoAsia

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Histoplasmosis has been reported in Sri Lanka for decades; however, clinical recognition and diagnosis of the disease are rare. We conducted a comprehensive search of English-language medical literature from 1969 to February 2022. Our analysis found one population survey of histoplasmin skin sensitivity testing in 1969 (5.7% positive incidence) and ten cases of histoplasmosis across Sri Lanka. The highest number of cases were reported from the Central province, where the positive histoplasmin tests were observed previously. None of the patients were positive for HIV, and both diabetes and betel chewing seem linked with oral histoplasmosis. Out of the reported cases, 50% were diagnosed with disseminated histoplasmosis; asymptomatic, acute pulmonary, and chronic pulmonary histoplasmosis were not observed. The clinical presentation varied from oral lesions (the most common presentation), skin lesions, and fever of unknown origin to adrenal crisis. Fungal culture and histopathology were used for diagnosis, with no use of antigen and antibody testing. Amphotericin B and itraconazole were used as treatment options. The rising at-risk population mandates enhancing laboratory diagnostic facilities and increasing the awareness of medical professionals in Sri Lanka on histoplasmosis.

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Section: Clinical Presentation Of Histoplasmosismentioning

confidence: 99%

Section: Clinical Presentation Of Histoplasmosismentioning

confidence: 99%

Section: Figure 3 Macroscopic (A) and Microscopic (40x) (B) Views Of ...mentioning

confidence: 99%

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Histoplasmosis in Sri Lanka – barely recognized, yet present

Sigera¹,

Jayasekera²,

Denning³

2023

MycoAsia

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“…12,14 These lesions could be nodular, ulcerative, verrucous, or plaque-like. 11 Oral histoplasmosis mimics other oral ulcerative lesions such as chronic traumatic ulcers, squamous cell carcinoma, lymphomas, Crohn disease, ulcerative necrotic gingivitis or stomatitis, tuberculosis, and necrotizing sialometaplasia. 2 Consequently, in the absence of proper awareness, the clinicians may misdiagnose the condition.…”

mentioning

confidence: 99%

“…2,8,10 A localized oral lesion without dissemination is an uncommon presentation. 2,11,12 Since oral lesions could be the primary manifestation of the dissemination, evaluation of the patient for the dissemination and possible immunocompromised condition is important. 13 These mucosal lesions appear in almost every part of the oral mucosa, yet the commonest sites are tongue, palate, and buccal mucosa.…”

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confidence: 99%

Histoplasma capsulatum Caused a Localized Tongue Ulcer in a Non-HIV Patient—A Case From Nonendemic Country

et al. 2019

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A 56-year-old male, smoker (25 cigarettes per day) for 30 years, was referred to the Oral Medicine Clinic, University Dental Hospital with nonhealing, gradually enlarging ulcer on tongue for 4 months.He complained of a painful ulcer over the left side of his tongue which was associated with odynophagia. He didn't have chronic cough, fever, malaise, loss of appetite or loss of weight, and systemic symptoms suggestive of inherited or acquired immunodeficiency including HIV.His past medical history was marked by diabetes mellitus and chronic obstructive pulmonary disease, and he was on oral hypoglycemic drugs.He denied past orofacial surgeries, trauma, high-risk sexual behavior, or long-term immunosuppressive drugs. This nonalcoholic patient had no history of traveling abroad.He was averagely built, afebrile male. Oral examination revealed a solitary, 2 Â 4 Â 1 cm size, tender, irregular ulcer on the left posterior tongue with indurations (Figure 1). The pain intensity was at 10 in the visual analog scale. There was no regional lymphadenopathy or hepatosplenomegaly. Rest of the general and systemic examinations were normal.

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Histoplasmosis masquerading as solitary oral ulcer: An unusual case report

Cited by 2 publications

References 9 publications

Histoplasmosis in Sri Lanka – barely recognized, yet present

Histoplasmosis in Sri Lanka – barely recognized, yet present

Histoplasma capsulatum Caused a Localized Tongue Ulcer in a Non-HIV Patient—A Case From Nonendemic Country

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