Oral Manifestations Associated to Paracoccidioidomicosis and Histoplasmosis

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.

Epidemiology of paracoccidioidomycosis in Venezuela: a retrospective study from 1954 to 2019

“…Therefore, skin and oral manifestations, along with high suspicion due to epidemiological information, must be a clue for physicians to suspect PCM infections. 14 , 31 , 41 …”

Nasal Septum Perforation Associated to Histoplasmosis: A Retrospective Study

“…Additionally, there are other sources for exposure to Histoplasma sp., including lumberjacking, street-swipping, and dovecotes cleansing, such as attics as suggested elsewhere. Considering the occupation of patients at the moment of the diagnosis may give an important epidemiological clue of risk factors [1,2,4,5,8,9].…”

“…in all samples reviewed. In some of the cases, it was the first positive result given to the patient, which allowed appropriate treatment in a short time [2,8,34].…”

“…In chronic disseminated histoplasmosis, ulcers in the tongue, hard palate and nasal septum may occur as a consequence of lymphohematic dissemination. Physicians of endemic areas such as Venezuela must consider histoplasmosis in the differential diagnosis of any chronic non-healing mucosal lesion [8].…”