Oral histoplasmosis in a transplant patient 50 F Midwest hx liver transplant on prednisone MMF fever, sweats, diarrhea, oral ulcers x3 d, hx of cmv, no improvement w/ganciclovir. Diagnosis? Oral histoplasmosis is rare & diagnosis is challenging. Involved sites include tongue, palate, oral mucosa, gingivae & pharynx. May occur as granular ulcerations, multiple painful ulcers & verrucous growth & mimic other infectious diseases or malignant tumors. Confused w/squamous cell ca so important to send not just for histology but for histopath. Center of lesion contains macrophages & yeast but edge may not Other differentials: CMV & HSV. CMV ulcers are generally chronic. - Indiana University Infectious Diseases Fellowship @IUIDfellowship #Oral #histoplasmosis #transplant #mouth #clinical #photo
