Oropharyngeal histoplasmosis: report of eleven cases and review of the literature

Revista da Sociedade Brasileira de Medicina Tropical

Vicente Sperb Antonello¹  Vanice Ferrazza Zaltron²  Marcela Vial²  Flávio Mattos De Oliveira²  Luiz Carlos Severo² 

[1] ,Hospital Nossa Senhora da Conceição Department of Infectious Diseases Porto Alegre RS ,Brazil

关键词: Histoplasmosis;    Histoplasma capsulatum;    HIV infection;    AIDS;    Histoplasmose;    Histoplasma capsulatum;    Infecção pelo HIV;    AIDS;   

DOI  :  10.1590/S0037-86822011000100007

来源: SciELO

【 摘 要 】

INTRODUCTION: Histoplasmosis is a systemic mycosis endemic in Brazil, especially in the State of Rio Grande do Sul, where Histoplasma capsulatum was isolated from the soil. H. capsulatum may compromise unusual areas, including the oropharynx, particularly in patients presenting disseminated histoplasmosis; which is associated with a state of immunosuppression, such as AIDS. METHODS: During database analysis of a total of 265 cases of histoplasmosis, the medical records of 11 patients with histological or microbiological diagnoses of oral histoplasmosis (OH) between 1987 and 2008 were retrospectively reviewed. RESULTS: This work reports 11 cases of OH, the majority presenting histopathological or microbiological evidence of disseminated histoplasmosis (DH). In the patients with DH, OH was the first manifestation of histoplasmosis. Five of the 11 patients discussed were HIV-seropositive with clinical and laboratory findings of AIDS. Four patients presented active pulmonary tuberculosis concomitant with histoplasmosis. Treatment was based on the use of itraconazole and amphotericin B deoxycholate. Eight patients responded successfully to therapy after one year, two did not come back for reevaluation and one died despite adequate therapy. CONCLUSIONS: Oral histoplasmosis is closely associated with immunosuppression status, especially in patients presenting AIDS; moreover, in many cases, OH is the first sign of disseminated histoplasmosis.

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