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Histoplasmosis - Oral Mucosal Lesion
See also in: Overview
Other Resources UpToDate PubMed

Histoplasmosis - Oral Mucosal Lesion

See also in: Overview
Contributors: Cristina Thomas MD, Heidi Bai, Kyle Cheng MD, Atoosa Ghofranian, Vivian Wong MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Histoplasmosis is an infection caused by the dimorphic Histoplasma capsulatum fungus. Oral histoplasmosis is usually a manifestation of disseminated histoplasmosis, which occurs when hematogenously disseminated organisms cannot be contained by the individual's immune system, either following primary infection or as a reactivation of disease. Rarely, oral histoplasmosis can represent primary localized disease.

Exposure may occur in regions such as the Central and Eastern United States, especially the Ohio and Mississippi River Valleys. Cases have also been reported in Central and South America, Africa, Asia, and Europe.

Oral histoplasmosis typically manifests as one or more tender intraoral nodules or ulcers with dysphagia and/or odynophagia. Fever, weakness, weight loss, lymphadenopathy, and hepatosplenomegaly frequently accompany oral histoplasmosis in immunocompromised patients; however, in some cases, patients appear well. Oral findings may also predate the onset of systemic symptoms and signs.

Predisposing factors include immunosuppression (including HIV, organ transplant, renal failure, and prolonged use of systemic corticosteroids and other immunosuppressants, including tumor necrosis factor alpha antagonists) and advanced age. Although the organisms are most commonly present in bird and bat excrement, patients frequently do not recall a definitive exposure.

Codes

ICD10CM:
B39.9 – Histoplasmosis, unspecified

SNOMEDCT:
12962009 – Histoplasmosis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis for intraoral ulcerated nodules and plaques is broad:

Autoimmune / inflammatory:
Infectious:
Neoplastic:
Chronic traumatic ulcers

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:11/19/2020
Last Updated:11/22/2020
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Histoplasmosis - Oral Mucosal Lesion
See also in: Overview
Histoplasmosis (Pulmonary) : Chest pain, Cough, Fever, Mediastinal lymphadenopathy
Clinical image of Histoplasmosis
Copyright © 2021 VisualDx®. All rights reserved.