Oral ulcerative lesions in a post-liver-transplantation patient

Autor: Gabriele Prospero Nakamura, Renata Mendonça Moraes, Juliana Mota Siqueira, Andrea Cruz Ferraz de Oliveira, Maria Dirlei Ferreira de Souza Begnami, Graziella Chagas Jaguar
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Autopsy and Case Reports, Vol 9, Iss 1 (2019)
Druh dokumentu: article
ISSN: 2236-1960
DOI: 10.4322/acr.2018.046
Popis: Oral involvement is rarely found in histoplasmosis, except in its disseminated form, which is mostly observed in the severely immunocompromised host. Herein, we presented the case of a 36-year-old female with a previous history of liver transplant, who was hospitalized due to fever, chills, night sweats, diarrhea, and painful oral lesions over the last 3 days. The oral examination revealed the presence of painful shallow ulcers lined by a pseudomembrane in the gingiva and the soft and hard palate. The initial working diagnosis comprised cytomegalovirus reactivation or herpes simplex virus infection. The diagnostic work-up included incisional biopsies of the gingiva and the sigmoid colon. Both biopsies confirmed the diagnosis of histoplasmosis. Intravenous itraconazole was administered with significant improvement after 7 days. Although oral involvement is rare, histoplasmosis should be included in the differential diagnosis of oral lesions, particularly when the patient is immunosuppressed. This study reports a rare presentation of histoplasmosis involving the mucosa of the oral cavity and the colon.
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