Primary Oral Histoplasmosis in Immunocompetent Host: Case Series with Review of Literature

Abstract

Histoplasmosis, a systemic mycosis caused by Histoplasma capsulatum manifests clinically in immunocompromised subjects as acute or chronic pulmonary infection or as a progressive disseminated disease. In oral region it clinically presents as multiple, granular and painful ulcers or verrucous growth. It is rare to find primary oral lesion of histoplasmosis in immunocompetent patient free from systemic disease. In presence of any unusual oral lesion possibility of Histoplasmosis should be considered and prompt diagnosis be attained with exclusion of false negative results as non-specific manifestation of disease may lead to gruesome misdiagnosis of lesion and inadequate treatment. In the present paper two cases of oral histoplasmosis in immunocompetent host have been discussed along with updated review of literature.

Keywords: Immunocompetent host; India; Oral histoplasmosis; Primary lesion.

Fig. 1

a A photograph of the ulceroproliferative lesion on the edentulous site extending from right mandibular lateral incisor to first premolar of case 1; b a photograph of the ulceroproliferative growth with necrotic base, everted margins on right buccal mucosa extending from right maxillary first molar upto pterygomandibular raphe of case 2

Fig. 2

a, b Photomicrographs reveal areas of intense granuloma formation with multinucleated giant cells containing intracytoplasmic round structures. (Hematoxylin & Eosin, 4×, 40×); c, d Photomicrograph reveals 2–5 µm organisms with clear halo within multinucleated giant cells, macrophages and also interspersed in connective tissue stroma. (Periodic Acid Schiff, 40×, Grocott-Gomori’s Methnanamine Silver, 40×)