Oropharyngeal histoplasmosis: report of eleven cases and review of the literature.
Open accessAbstract
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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Early in the HIV pandemic, reports demonstrated an increased risk of death associated with advanced AIDS, immunocompromised states, chronic renal disease, and prolonged use of corticosteroids or TNF antagonists.
“Early in the HIV pandemic, reports of Histoplasma spp. outbreaks [164–166] demonstrated an increased risk of death associated with advanced AIDS (CD4 counts <75 mm3), immunocompromised states (such as solid organ transplantation), chronic renal disease, and prolonged use of corticosteroids or tumor necrosis factor (TNF) antagonists [164,166,167].”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [166]
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- Authors
- Antonello, V. S., Zaltron, V. F., Vial, M., Oliveira, F. M. D., & Severo, L. C.
- Affiliations
- Hospital Nossa Senhora da Conceição (BR)
- Santa Casa Hospital (BR)
- Universidade de Passo Fundo (BR)
- Complexo Hospitalar Santa Casa de Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul (BR)
- Venue
- Revista da Sociedade Brasileira de Medicina Tropical
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2011-02
- Volume
- 44
- Issue
- 1
- Pages
- 26-29
- ISSN
- 0037-8682 (ISSN-L)
- OpenAlex
- W2126175311
- Cited by
- 55
- References
- 16
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 6 · 2016: 2 · 2015: 3 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Revista da Sociedade Brasileira de Medicina Tropical (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, cc-by-nc)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Lume (Universidade Federal do Rio Grande do Sul) (submittedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
- Topics
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Health Sciences › Medicine › Physiology › Histiocytic Disorders and Treatments
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Keywords
- oral histoplasmosis, Histoplasma capsulatum, disseminated histoplasmosis, AIDS, immunosuppression, pulmonary tuberculosis, itraconazole, amphotericin B deoxycholate, Rio Grande do Sul
- MeSH terms
- Adult, Aged, Amphotericin B, Antifungal Agents, Deoxycholic Acid, Drug Combinations, Female, Histoplasmosis, Humans, Ketoconazole, Male, Middle Aged, Oropharynx, Pharyngeal Diseases, Retrospective Studies, AIDS-Related Opportunistic Infections, Itraconazole, Young Adult
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