title: Oral histoplasmosis in Brazil.
abstract: OBJECTIVE
  We report 10 cases of histoplasmosis with oral manifestations seen in a teaching hospital in Brazil.
  
  
  METHODS
  This is a retrospective study of the sociodemographic, clinicopathologic, and treatment data of these cases.
  
  
  RESULTS
  Overall, 8 of 10 cases were seropositive for human immunodeficiency virus (HIV), whereas 2 were negative. The predominant oral manifestations found in HIV-seropositive patients were ulcers, oral pain, and odynophagia; both of the HIV-seronegative patients were symptom-free. HIV infection was suspected in 7 cases because of the presence of oral lesions of histoplasmosis. Asthenia, fever, weight loss, lymphadenopathy, and hepatosplenomegaly were found only in HIV-seropositive patients. Radiographs in 3 out of 10 patients suggested pulmonary involvement. Amphotericin B was the antifungal therapy chosen, and clinical remission of oral lesions occurred in an average of 30 days (accumulated doses: 500-1500 mg). Itraconazole was very effective as a follow-up treatment in terms of prevention of recurrence.
  
  
  CONCLUSIONS
  Histoplasmosis only rarely affects HIV-seronegative patients; however, the possibility of hidden immunodepression should be considered when oral manifestations of histoplasmosis are present.
authors.affiliation: Dental College, Universidade Federal Uberlândia, Brazil.
authors.forename: Orgânia Gomes
authors.initials: OG
authors.lastname: Ferreira
authors.forename: Sérgio Vitorino
authors.initials: SV
authors.lastname: Cardoso
authors.forename: Aércio S
authors.initials: AS
authors.lastname: Borges
authors.forename: Marcelo Simão
authors.initials: MS
authors.lastname: Ferreira
authors.forename: Adriano Mota
authors.initials: AM
authors.lastname: Loyola
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000473:pathology; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001938:Brazil; D005260:Female; D006679:HIV Seropositivity / Q000150:complications; D006660:Histoplasmosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B