Isolated Histoplasmosis of Tongue: A Case Report with Review of the Literature

摘要

Histoplasmosis is a systemic fungal disease. Oral histoplasmosis usually occurs in association with the chronic disseminated form of the disease and isolated oral presentation is rare. A case of isolated histoplasmosis involving the tongue in a HIV-negative patient is being reported. Introduction The clinical picture of histoplasmosis ranges from asymptomatic infection to life-threatening illness depending upon the intensity of the exposure, immune status of the individual, and the lung architecture of the host. Progressive disseminated histoplasmosis is typically seen in immunocompromised individuals. Common risk factors include acquired immune deficiency syndrome, extremes of age, and anti-TNF- α agents.1 The muco-cutaneous lesions are rare and should always be considered a manifestation of disseminated disease.2 A case of isolated tongue histoplasmosis in a HIV negative patient is being presented. Case Report A 40 years old male patient presented with ulcer on the tongue of three months duration. The ulcer was slowly increasing in size and was associated with pain, odynophagia and some difficulty in speech. There was no history of travel to farm or caves. There was no history of oral trauma. He was non-alcoholic, non-smoker, non-diabetic. Past history was negative for tuberculosis. The general physical examination was normal. Examination of oral cavity revealed poor oro-dental hygiene. A large ulcer of size 1.2 x 2.6 cm. was seen on the base of the tongue. Another small ulcer of size 0.7 x 0.7 cm was also noticed near the tip on the dorsal surface on the left side of midline of the tongue. The margins of the ulcer were raised and edematous. The floor of the ulcer was covered with thick secretions. On palpation, the ulcer was tender and indurated. (Fig 1)