Disseminated histoplasmosis with oral and cutaneous manifestation in an immunosuppressed patient - A case report

Histoplasmosis is a granulomatous fungal disease caused by Histoplasma capsulatum. This microorganism is found in soil rich in excreta of bats and birds. Histoplasmosis has variable clinical features. It is usually self-limiting or localized in immunocompetent individuals. On the other hand, it occurs in the disseminated form in 95% of patients with HIV/AIDS. This article describes a case of oral histoplasmosis in an immunosuppressed patient. A 39-year-old male was admitted to the Hospital Oswaldo Cruz complaining of oral soreness. Several ulcerations were observed on the lips, soft palate, tongue, and skin. The patient reported weight loss, appetite loss and fever. A biopsy was realized and microscopic examination showed chronic inflammatory infiltrate, collections of macrophages, and H. capsulatum. Itraconazole and Amphotericin B were used in the treatment and all lesions disappeared three months later. Oral manifestations of histoplasmosis may be exacerbated in patients with HIV/AIDS. Thus, the examination of the mouth and oropharynx should be performed in patients suspected of histoplasmosis.