Oral ulcerative lesions in a post-liver-transplantation patient

Authors

  • Gabriele Prospero Nakamura AC Camargo Cancer Center, Stomatology Department
  • Renata Mendonça Moraes AC Camargo Cancer Center, Stomatology Department
  • Juliana Mota Siqueira AC Camargo Cancer Center, Stomatology Department
  • Andrea Cruz Ferraz de Oliveira AC Camargo Cancer Center, Pathologic Anatomy Department
  • Maria Dirlei Ferreira de Souza Begnami AC Camargo Cancer Center, Pathologic Anatomy Department
  • Graziella Chagas Jaguar AC Camargo Cancer Center, Stomatology Department

DOI:

https://doi.org/10.4322/acr.2018.046

Keywords:

Histoplasmosis, Liver Transplantation, Oral ulcer, Immunosuppression

Abstract

Oral involvement is rarely found in histoplasmosis, except in its disseminated form, which is mostly observed in the severely immunocompromised host. Herein, we presented the case of a 36-year-old female with a previous history of liver transplant, who was hospitalized due to fever, chills, night sweats, diarrhea, and painful oral lesions over the last 3 days. The oral examination revealed the presence of painful shallow ulcers lined by a pseudomembrane in the gingiva and the soft and hard palate. The initial working diagnosis comprised cytomegalovirus reactivation or herpes simplex virus infection. The diagnostic work-up included incisional biopsies of the gingiva and the sigmoid colon. Both biopsies confirmed the diagnosis of histoplasmosis. Intravenous itraconazole was administered with significant improvement after 7 days. Although oral involvement is rare, histoplasmosis should be included in the differential diagnosis of oral lesions, particularly when the patient is immunosuppressed. This study reports a rare presentation of histoplasmosis involving the mucosa of the oral cavity and the colon.

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Published

2019-08-14

How to Cite

Nakamura, G. P., Moraes, R. M., Siqueira, J. M., Oliveira, A. C. F. de, Begnami, M. D. F. de S., & Jaguar, G. C. (2019). Oral ulcerative lesions in a post-liver-transplantation patient. Autopsy and Case Reports, 9(1), e2018046. https://doi.org/10.4322/acr.2018.046

Issue

Section

Article / Clinical Case Report