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June 19, 1967

Histoplasma Ulcer of the Tongue

JAMA. 1967;200(12):1130-1131. doi:10.1001/jama.1967.03120250164028

HISTOPLASMOSIS usually occurs as a benign self-limited pulmonary disease. It may also assume a progressive course to involve not only the lungs but multiple organ systems in the body. Pneumonitis, endocarditis,1 paricarditis,2 erythema nodosum, erythema multiforme,3 and oral mucocutaneous lesion4,5 have all been described.

Studies by many investigators during the past decade have shown that the prevalence of histoplasmosis is more widespread than once realized. Extensive epidemiologic studies in endemic areas show a positive result from the histoplasmin skin test in greater than 75% of the population. The prognosis of untreated disseminated histoplasmosis is extremely poor.6 The treatment of disseminated histoplasmosis is presently limited to the use of amphotericin B, an effective but highly toxic drug.7

This report describes a case of proven disseminated histoplasmosis which presented as an ulceration of the tongue. There was an immediate and sustained response to therapy with amphotericin B