Clinical and histopathological presentation of Histoplasmosis in the oral cavity - A Systematic review

Objective: Oral lesions can be an early indicator of systemic histoplasmosis, especially in immunocompromised patients. The main aim of this review was to summarise demographic and clinical findings and correlate them with histopathological findings. Material and Methods: The literature search included articles published on oral histoplasmosis from databases like PubMed, Scopus, Web of Science, and EMBASE. The included articles provided information regarding sociodemographic and clinical data, human immunodeficiency virus (HIV) infection status, histopathological features, treatment, and outcome. This review included 30 case reports encompassing a total of 92 individual cases, of which 34 were HIV‑positive. Results: The oral manifestation was observed as a disseminated form in all HIV patients. Oral histoplasmosis is clinically presented as a painful ulcerated lesion commonly seen in the tongue, gingiva, palate, and buccal mucosa. Histopathologically, sheets of histiocytes with yeast-like cells, inflammatory infiltrate, and multinucleated giant cells were seen. Histopathological findings are essential for an early diagnosis of oral histoplasmosis since it could mimic other diseases clinically. Itraconazole was found to be an effective treatment for oral histoplasmosis. Conclusions: Oral lesions of histoplasmosis can occur in non-endemic countries and immunocompetent individuals. Histopathological findings are essential for an early diagnosis of oral histoplasmosis since it could mimic other diseases clinically.