Oral Biosciences & Medicine
Oral Biosci Med 2 (2005), No. 4     27. Jan. 2006
Oral Biosci Med 2 (2005), No. 4  (27.01.2006)

Page 253-257

Oral Histoplasmosis Associated with HIV Disease: Report of two Cases from Thailand
Siwamogstham, P./Reichart, P. A./Thosaporn, W./Prapamonton, N.
Introduction: Histoplasmosis caused by Histoplasma capsulatum (Hc) rarely affects the oral mucosa. Oral histoplasmosis (OH) may occur both in the immunocompetent individual as well as in patients with HIV-infection and AIDS. The majority of cases has been observed in the United States and South America. In South and Southeast Asia OH seems to be rare.
Patients and Methods: Two cases of OH in two Thai male patients (aged 30 and 43 years) are described. Clincally, ulcerated lesions with indurated borders were seen, which had persisted for some time. Biopsies revealed the Hc organism. Therapy consisted of administration of ketoconazole, itraconazole and/or amphotericin B. One patient was lost to follow-up, in the other complete healing of the oral lesions occurred.
Conclusions: Oral histoplasmosis in HIV-infected patients in Thailand is rare. The diagnosis is made on histopathologic and serologic parameters. Patients with active antiretroviral therapy or highly active antiretroviral therapy are unlikely to develop OH due to immunereconstitution.

Keywords: histoplasmosis, oral, HIV infection, Thailand