Histoplasmosis of the oral cavity, oropharynx and larynx

Abstract

A patient with oropharyngolaryngeal histoplasmosis is presented. He has been treated for disseminated tuberculosis (TB) for 10 months, with no improvement.Repeat biopsy of a tongue ulcer, together with a swab of the ulcer base, confirmed the presence of Histoplasma capsulatum.Treatment with amphotericin B resulted in a rapid recovery.

Histoplasmose de laringe

“…1 It must especially be considered in patients who do not respond to tuberculosis treatment, in whom the tuberculosis agent was not identified. 5 Differently from the patients with the spread form of the disease, these here do not have the involvement of other organs (muco-cutaneous, meningitis, pericarditis, adrenal failure forms of the disease). Staloff et al 2 commented that the spread is very rare, as a clinically apparent infection, happening more frequently in immunosuppressed and elderly patients, and more commonly in men.…”

“…6 It is also common for these patients to complain of weight loss, malaise and fatigue. 5 Hepatoesplenomegaly can occur in 30-50% of the cases, as well as skin ulcerations. Mucosa ulcerations are the most frequent findings in these patients.…”

Primary Histoplasmosis of Larynx: A Case Series and Review of Literature

“…Though clinically these may create confusion but characteristic microscopic appearance more or less confirms the diagnosis. Rajah [17] treated, what he thought was tuberculosis in one of his patients for 10 months before the correct diagnosis, while Staloff et al [18] had their patient undergo two surgical procedures by another team with the diagnosis of vocal fold polyps, and later they suspected of papillomatosis. Gerber et al [19] carried out chemotherapy and radiotherapy to treat cancer for 2 to 3 months, without improvement and achieved good results after instating proper treatment.…”

“…Amphotericin B was used in initial 3 cases with recurrence in 1 case after 6 months and signs of nephrotoxicity in another, but with use of Itraconazole in rest 7 cases, no recurrence or side effect was noted. Amphotericin B remains the gold standard for treatment and is highly effective, even in immunocompromised individuals; Itraconazole shows promise as an alternative to Amphotericin b for treatment of less severely ill patients [16][17][18].…”

Molecular Detection of Cellulosimicrobium cellulans as the Etiological Agent of a Chronic Tongue Ulcer in a Human Immunodeficiency Virus-Positive Patient

“…Candida spp. are the most frequently found fungi, but other fungi, such as Cryptococcus neoformans and H. capsulatum, may cause oral manifestations, including palatal and lingual ulcers and granulomas and nodular ulcerative lesions (7,14,17). Bacteria known to cause oral ulcerations include Treponema pallidum and some actinobacteria, especially Mycobacterium tuberculosis (20).…”