Lingual Histoplasmosis in an Elderly Japanese Woman

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  • Katto Mai
    Department of Otorhinolaryngology Nishi-Kobe Medical center Kobe(Current address: Department of Otorhinolaryngology-Head and Neck surgery, Steel Memorial Hirohata Hospital)
  • Kumoi Kazuo
    Department of Otorhinolaryngology Nishi-Kobe Medical center Kobe

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Other Title
  • 舌生検で診断し得たヒストプラズマ症
  • 症例報告 舌生検で診断し得たヒストプラズマ症
  • ショウレイ ホウコク ゼツセイケン デ シンダン シエタ ヒストプラズマショウ

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Abstract

<p>　We report the case of a 79-year-old Japanese woman who presented to use with a 1-to 2-week history of a gradually developing lingual mass. Past history included rheumatoid arthritis and miliary tuberculosis. Histopathological examination of hematoxylin/eosin-stained lingual biopsy sections showed epithelioid granulomas. Fungus-like pathogens were suspected from the results of Grocott and periodic acid-Schiff (PAS) stainings.</p><p></p><p>　In addition, positive results for serum anti-Histoplasma antibodies were obtained by enzyme-linked immunosorbent assay, and broad-range PCR sequencing in the 26S rRNA field showed positive findings for Histoplasma capsulatum with 99.8% homology. Finally, the patient was diagnosed as having lingual histoplasmosis, and treatment with itraconazole was initiated. The response to the treatment was good, and no recurrence has been seen as of now, more than 1 year since the treatment completion.</p><p></p><p>　Solitary lingual histoplasmosis is a very rare disease, and the possibility of the patient already having developed disseminated histoplasmosis at the time that she was treated for miliary tuberculosis was considered. In Japan, histoplasmosis is considered to be an infectious disease associated with travel overseas, but our patient gave no such history. This suggests that Histoplasma is present in Japan and can infect humans.</p>

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