RESUMO
This case report describes an uncommon manifestation of histoplasmosis on the soft palate. The importance of appropriate treatment and follow-up in complex cases is emphasized, especially in patients with chronic diseases. Oral lesions may occur as multiple, granular and painful ulcers, as well as verrucous growths. Lesions may also be deep, with infiltrative edges and erythematous or with white areas, accompanied by local lymphadenopathy, resembling a carcinoma on clinical examination. In this sense, a fast and accurate diagnosis is essential to the success of treatment of oral histoplasmosis.
Assuntos
Histoplasmose/patologia , Úlceras Orais/microbiologia , Úlceras Orais/patologia , Palato Mole/microbiologia , Palato Mole/patologia , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Biópsia , Evolução Fatal , Histoplasmose/tratamento farmacológico , Humanos , Itraconazol/uso terapêutico , Masculino , Úlceras Orais/tratamento farmacológicoRESUMO
AbstractParacoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis. It occurs more frequently in its chronic form, which particularly affects male adults from rural areas. These patients present with pulmonary involvement and systemic symptoms. Skin and mucosal lesions are rather typical and might suggest the diagnosis. The involvement of the upper airway mucosa is common and the patients usually complain of dysphagia and dysphonia. Nonetheless, in endemic areas, physicians should maintain a high level of suspicion even when faced with some atypical symptoms. We present the case of an adult diagnosed with nasopharyngeal paracoccidioidomycosis after presenting with an unusual otolaryngologic syndrome including unilateral soft palate paralysis with velopharyngeal insufficiency and hearing loss secondary to middle ear effusion.
Assuntos
Perda Auditiva/diagnóstico , Otite Média com Derrame/diagnóstico , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/diagnóstico , Adulto , Anti-Infecciosos , Orelha Média/microbiologia , Orelha Média/patologia , Perda Auditiva/tratamento farmacológico , Perda Auditiva/microbiologia , Perda Auditiva/patologia , Humanos , Masculino , Ventilação da Orelha Média , Nasofaringe/microbiologia , Nasofaringe/patologia , Otite Média com Derrame/tratamento farmacológico , Otite Média com Derrame/microbiologia , Otite Média com Derrame/patologia , Palato Mole/microbiologia , Palato Mole/patologia , Paracoccidioides/efeitos dos fármacos , Paracoccidioides/patogenicidade , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/microbiologia , Paracoccidioidomicose/patologia , Resultado do Tratamento , Combinação Trimetoprima e SulfametoxazolRESUMO
Abstract This case report describes an uncommon manifestation of histoplasmosis on the soft palate. The importance of appropriate treatment and follow-up in complex cases is emphasized, especially in patients with chronic diseases. Oral lesions may occur as multiple, granular and painful ulcers, as well as verrucous growths. Lesions may also be deep, with infiltrative edges and erythematous or with white areas, accompanied by local lymphadenopathy, resembling a carcinoma on clinical examination. In this sense, a fast and accurate diagnosis is essential to the success of treatment of oral histoplasmosis.