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Histoplasmosis - Oral Mucosal Lesion
See also in: Overview,Pulmonary
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Histoplasmosis - Oral Mucosal Lesion

See also in: Overview,Pulmonary
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Contributors: 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 in bird and bat feces. 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.

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 human immunodeficiency virus [HIV], organ transplantation, renal failure, prolonged use of systemic corticosteroids and other immunosuppressants, including tumor necrosis factor alpha antagonists) and advanced age.

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: 04/17/2016
Last Updated: 06/08/2016
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Histoplasmosis - Oral Mucosal Lesion
See also in: Overview,Pulmonary
Print 8 Images
View all Images (8)
(with subscription)
Histoplasmosis (Pulmonary) : Chest pain, Cough, Fever, Mediastinal lymphadenopathy, Plaque with ulcer
Clinical image of Histoplasmosis
Copyright © 2019 VisualDx®. All rights reserved.