PMC6875186_01
Clinical aspect of intraoral lesions in the palate and alveolar ridge regions (a, b).
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fig1
The intraoral physical examination revealed diffuse, friable, vegetative areas on the right upper alveolar ridge, hard palate, and left inferior alveolar ridge (Figures 1(a) and 1(b)).
Connective tissue with intense inflammatory infiltrate with a granulomatous pattern, consisting of giant multinucleated inflammatory cells and vacuolated macrophages, with several fungi suggestive of H. capsulatum:(hematoxylin-eosin stain; (a) x200, (b) x400). In (c) and (d), the periodic acid-Schiff (PAS) staining showed vacuolated macrophage with positivity for H. capsulatum ((c d) x400). Note the numerous small rosy dots (arrow).
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fig2
An incisional biopsy of the right upper alveolar ridge showed connective tissue with intense inflammatory infiltrate with a granulomatous pattern, consisting of giant multinucleated inflammatory cells and vacuolated macrophages, with innumerable fungi suggestive of H. capsulatum (Figures 2(a) and 2(b)). Staining slides with periodic acid-Schiff (PAS) (Figures 2(c) and 2(d)) and Grocott-Gomori methenamine silver were positive for the morphological characteristics of H. capsulatum.
After twelve months, the clinical regression of oral histoplasmosis lesions.
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fig3
The clinical control one year after initiation of itraconazole treatment can be seen in Figures 3(a) and 3(b).