Oral histoplasmosis in Brazil.
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.
Ferreira
Orgânia Gomes
OG
Dental College, Universidade Federal Uberlândia, Brazil.
Cardoso
Sérgio Vitorino
SV
Borges
Aércio S
AS
Ferreira
Marcelo Simão
MS
Loyola
Adriano Mota
AM
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
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B