Background Oral histoplasmosis is an uncommon opportunistic fungal infection rarely encountered in non-endemic regions. It may present as a chronic non-healing ulcer and can mimic infectious, traumatic, or neoplastic lesions, leading to diagnostic delay. In immunocompromised individuals, particularly those with advanced acquired immunodeficiency syndrome (AIDS), oral manifestations may serve as early or sentinel signs of systemic disease.Case Description This case report describes a male patient in his 40s who presented with a painless, non-healing ulcer in the mandibular labial vestibule, clinically suspected to be a chronic infectious or neoplastic lesion. Serological investigations revealed HIV-1/2 reactivity confirmed by Western blot assay. Histopathological examination demonstrated granulomatous inflammation with numerous intracellular spores, consistent with oral histoplasmosis. A definitive diagnosis of oral histoplasmosis associated with HIV infection was established. The patient was initiated on antiretroviral therapy (ART) along with systemic itraconazole. Complete clinical resolution of the lesion was achieved, and sustained virologic suppression was observed at 12-month follow-up. This case underscores the importance of considering oral histoplasmosis as a potential indicator of underlying AIDS, even in non-endemic areas, and highlights the need for prompt diagnosis and integrated medical management.
Patil et al. (Thu,) studied this question.