Histoplasmosis of the Oral Cavity and Larynx: A Clinicopathologic Study

IT IS now recognized that in over 95% of cases the primary infection with histoplasmosis is subclinical or else presents as a mild respiratory illness.¹ Calcified splenic and hepatic granulomas show that miliary spread from the primary complex often occurs,² but progression to a clinically disseminated and debilitating infection is extremely rare. Recent evidence indicates that most clinically apparent cases of histoplasmosis in adults are the result of exogenous reinfection.³ These reinfections are usually mild self-limited illnesses, but progression into a chronic disorder mimicking tuberculosis can occur, and dissemination may be a complication. Although the majority of cases of reinfection histoplasmosis present as pulmonary syndromes, the dominant manifestations may in a minority of cases involve other organ systems. When such is the case, histoplasmosis is seldom suspected, as was well illustrated in a recent study of gastrointestinal histoplasmosis at this institution.⁴ Mucosal involvement is not uncommon in both acute and