Introduction:

Histoplasmosis is a mycosis caused by Histoplasma capsulatum. This fungus is found in the feces of some animals (bats and birds) and its reservoir is the soil. Histoplasmosis is an endemic disease in the American continent. Inhalation of spores causes primary pulmonary infection, which may in turn be disseminated.

Objective:

Describe a case of oral histoplasmosis in a patient seronegative to the human immunodeficiency virus.

Clinical case:

A case is presented of a diabetic, smoker and alcoholic patient with fever of several months' evolution and respiratory manifestations. Examination revealed ulcers in the patient's gums and tongue, as well as nodular lesions in the mouth mucosa, the bottom of the vestibular sulcus and the alveolar ridge. Laboratory testing found anemia, leucopenia and an increased globular sedimentation rate. The diagnosis was confirmed by cytology and histopathology. The treatment indicated was 200 mg itraconazole three times a day and then 200 mg twice a day for two months, and a daily tablet for six months after the second month. The patient is now asymptomatic and the oral lesions have disappeared.

Conclusions:

Histoplasmosis is mainly diagnosed by epidemiological testing, clinical examination and culture. Cytopathologic and histopathological analysis of the ulcer confirm the diagnosis. The case illustrates an infrequent form of presentation of the disease, not usually suspected but possible. The study is a warning to dentists, maxillofacial specialists and all the health personnel caring for patients with systemic manifestations.

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