Case Report
Disseminated Histoplasmosis with Oral Manifestation in
an Immunocompetent Patient
Debopriya Chatterjee,
1
Aishwarya Chatterjee,
2
Manoj Agarwal,
3
Meetu Mathur,
4
Setu Mathur,
1
R. Mallikarjun,
5
and Subrata Banerjee
6
1
Department of Periodontics, Government Dental College, Jaipur, India
2
SMS Dental Department, SMS Medical College, Jaipur, India
3
Department of Endodontics, Government Dental College, Jaipur, India
4
Department of Endodontics, Rajasthan Dental College, Jaipur, India
5
Department of Prosthodontics, AB Shetty Dental College, Karnataka, India
6
Department of Medicine, SMS Medical College, Jaipur, India
Correspondence should be addressed to Debopriya Chatterjee; banerjee.debo@gmail.com
Received 3 June 2016; Accepted 14 August 2016; Published 31 January 2017
Academic Editor: Adriano Loyola
Copyright © 2017 Debopriya Chatterjee et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. he patient
presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in
the palate. Histoplasmosis was conirmed by biopsy and histopathology of skin and palatal lesions. his case report highlights the
presenting features and occurrence of histoplasmosis in nonendemic region in India.
1. Introduction
Histoplasmosis is a dimorphic fungus, which grows in the
yeast form in infected tissues. It was irst identiied by Samuel
Darling in 1905, hence known as Darling’s disease. Infection
is mainly caused by inhalation of droppings from infected
birds or bats. Histoplasma capsulatum mainly infects the
lungs and passes asymptomatically to involve the skin and
reticuloendothelial system [1].
Clinically, histoplasmosis has been classiied as (i) pri-
mary acute pulmonary, (ii) chronic pulmonary, (iii) dissemi-
nated form, and (DH) occurring in infants, elderly, or immun-
ocompromised patients [2]. In human immunodeiciency
virus (HIV) positive patients, 95% of histoplasmosis appears
as disseminated infection. Occurrence of disseminated form
of histoplasmosis is very rare in HIV seronegative patients [3].
he manifestations of disseminated form of histoplasmo-
sis are fever, weakness, weight loss, hepatosplenomegaly, and
mucocutaneous lesions. he oral lesions may occur in any
part of the oral cavity and the lesions vary from nodules
to painful shallow or deep ulcers [4]. he incidence of oral
manifestation is 25–45% in the disseminated form of the
disease [3].
Skin lesions range from papules and plaques with or
without crusts, pustules and nodules to mucosal ulcers and
erosions, molluscum contagiosum-like lesions, acneiform
eruptions, erythematous papules, and keratotic plaques [5].
Although worldwide in distribution, in India, histoplas-
mosis seems to be prevalent in the Gangetic delta. Panja and
Sen reported the irst case of disseminated histoplasmosis
from Calcutta in 1954 and since then individual cases have
been reported from various states, mostly from West Bengal.
Among the forms of histoplasmosis reported from India,
disseminated histoplasmosis is the rarest [1].
2. Case Report
A 60-year-old female was referred from a private practitioner
to Dental Department of SMS Medical College Jaipur, with
swelling of lower limbs and abdomen for past 3 months. She
Hindawi Publishing Corporation
Case Reports in Dentistry
Volume 2017, Article ID 1323514, 4 pages
https://doi.org/10.1155/2017/1323514