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Ulcerated, granular proliferation at the extraction site of teeth #20–21 (a) periapical radiograph of tooth #22 showing an irregular radiolucency with widened PDL and loss of lamina dura (b) H&E and GMS stained sections showing subacutely inflamed granulation tissue and necrotic debris in association with large and occasionally budding yeast forms consistent with Blastomyces dermatitidis: × 600 (c, d) clinical resolution of the soft tissue lesion with persistent bone destruction 2 months after initiation of antifungal treatment (e, f) and post-operative panoramic radiograph depicting surgical resection with plate reconstruction (g)
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Deep fungal infections rarely involve the oral cavity and most commonly affect immunocompromised patients. Oral deep fungal infections typically manifest as chronic mucosal ulcerations or granular soft tissue overgrowths. Since these lesions are non-specific and can mimic malignancy, it is crucial to obtain a thorough clinical history and an adequa...
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Histoplasmosis is a rare fungal infection caused by the dimorphic species Histoplasma (H.) capsulatum, found in the Midwest and Central United States. Infection with H. capsulatum is observed in other regions beyond the Ohio and Mississippi River valley, including Mexico and Central and South America. There have been increasing reports of the disea...
Disseminated Histoplasmosis, a systemic fungal infection caused by Histoplasma capsulatum is predominantly seen in immunocompromised cases. It is usually endemic, although sporadic cases have been reported. Following initial infection to the lungs, it disseminates to various organs by lymphatic and hematogenous routes. Clinical features are non-spe...
Citations
... Infections like oral candidiasis, histoplasmosis, and blastomycosis present with lesions that may resemble malignancies. Management involves antifungal therapies such as itraconazole, supplemented by amphotericin B in severe cases (26,27). ...
Background: Oral ulcers significantly impact patient quality of life, manifesting as acute or chronic lesions that can cause considerable discomfort and pain. These ulcers arise from a variety of etiological factors and disrupt daily activities due to the painful loss of mucosal tissue. Objective: This review aims to elucidate the etiology and management of oral ulcers, with a focus on innovative treatment modalities involving hydrogels and exosomes. Methods: We reviewed current literature on the pathology and treatment of oral ulcers. Special attention was given to the properties of hydrogels and exosomes, their biomedical applications, and their roles in new therapeutic strategies for oral ulcers. Results: Hydrogels, due to their biocompatibility, biodegradation, and controlled release properties, have emerged as effective drug delivery systems. Exosomes, loaded within these hydrogels, enhance treatment outcomes due to their high cellular communication capacity and anti-inflammatory properties. Conclusion: Innovative treatments utilizing hydrogels and exosomes offer promising alternatives for the management of oral ulcers, potentially improving drug delivery efficiency and patient compliance.
... En odontología son muy comunes las patologías micóticas, por lo que el odontólogo debe estar entrenado para reconocer estas en una etapa temprana, ya que muchas de las lesiones comienzan como úlceras, puntos rojos sangrantes o infiltraciones de labios y de lengua; de igual forma se pueden observar otros efectos en orofaringe y la mucosa oral en general (1) . ...
Resumen Introducción: La paracoccidioidomicosis, es una micosis endémica en diferentes países de latinoamérica, incluyendo zonas de Colombia, con manifestación clínica muy variada ya que es considerada una enfermedad que puede ser crónica y sistémica. Objetivos: Exponer la importancia del examen clínico-estomatológico en la detección de diferentes entidades en sistema estomatognático, y el manejo multidisciplinario de paracoccidioidomicosis oral y sistémica. Caso clínico: paciente masculino en sexta década de vida, el cual presenta glosalgia y dolor de región ocular. Clínicamente presenta lesión de tipo granulomatoso en bordes laterales de lengua con evolución de hace 1 año aproximadamente, el resultado de la biopsia es paracoccidioidomicosis, se inicia manejo multidisciplinario con medicamentos intravenosos y orales, luego de 10 meses presenta resolución de este. Conclusiones: un buen interrogatorio, análisis de cuadro clínico y exámenes complementarios, son claves para un diagnóstico temprano y tratamiento oportuno, preservando la vida del paciente, espe-cialmente en infecciones oportunistas como la paracoccidioidomicosis. Palabras clave: paracoccidioidomicosis; micosis; infecciones fúngicas invasoras, condicio-nes patológicas, signos y síntomas; micobioma (DeCS). Introducción En odontología son muy comunes las patolo-gías micóticas, por lo que el odontólogo debe estar entrenado para reconocer estas en una eta-pa temprana, ya que muchas de las lesiones co-mienzan como úlceras, puntos rojos sangrantes o infiltraciones de labios y de lengua; de igual forma se pueden observar otros efectos en oro-faringe y la mucosa oral en general (1). La paracoccidioidomicosis es considerada una enfermedad multifocal que puede llegar a ser sistémica, es causada por un agente etiológico de origen micótico llamado paracoccidioides spp (2). La especie más prevalente es la paracocci-dioides brasiliensis, es del grupo de los hongos dismórficos o mohos levaduriformes, estos tie-nen la capacidad de cambiar su morfología y metabolismo para poderse adaptar al ambiente, lo que les da una ventaja biológica y es su prin-Abstract Introduction: Paracoccidioidomycosis is an endemic mycosis in different Latin Ameri-can countries, including areas of Colombia, with a very varied clinical manifestation since it is considered a disease that can be chronic and systemic. Objectives: To expose the importance of the clinical-stomatologi-cal examination in the detection of different entities in the stomatognathic system, and the multidisciplinary management of oral and systemic paracoccidioidomycosis. Clinical case: male patient in the sixth decade of life, who presented glossalgia and pain in the ocular region. Clinically, it presents a granulomatous-type lesion on the lateral edges of the tongue with evolution of approximately 1 year ago, the result of the biopsy is paracoccidioidomycosis, multidisciplinary management is started with intravenous and oral medications, after 10 months it resolves. Conclusions: a good questioning, analysis of the clinical picture and complementary tests are key to early diagnosis and timely treatment, preserving the patient's life, especially in opportunistic infections such as paracoccidioidomycosis.
... Blastomycosis can occasionally involve the oral cavity, particularly in disseminated cases. Oral manifestations of blastomycosis may include ulcers, nodules, or verrucous lesions on the oral mucosa, tongue, or palate [35]. These lesions can be painful and may be mistaken for other oral conditions, such as oral cancer or fungal infections like histoplasmosis. ...
Zoonotic diseases, transmitted between animals and humans, have significant implications on public health, including oral health. This chapter aims to provide a comprehensive overview of the oral manifestations of zoonotic diseases and their prevention, highlighting the importance of early recognition and management by dental professionals. The chapter will discuss the various oral manifestations associated with common zoonotic diseases, such as periodontal manifestations, mucosal lesions, and salivary gland disorders, emphasizing the need for accurate diagnosis and timely referral to appropriate healthcare providers. Moreover, the chapter will delve into the role of dental professionals in preventing zoonotic disease transmission in clinical settings. It will explore the significance of education and training in recognizing and managing the oral manifestations of zoonotic diseases. Additionally, the chapter will emphasize the implementation of preventive measures, including the appropriate use of personal protective equipment, adherence to stringent infection control protocols, and the development of animal handling policies. By highlighting the intricate relationship between oral health and zoonotic diseases, this chapter aims to underscore the critical role of dental professionals in safeguarding the health and well-being of their patients and communities.
... Oral mycosis or fungal infections can be further categorized into super cial and deep. The latter rarely involves oral cavity; however, it may occur in immunocompromised individuals (3). Deep-seated mycotic infections present a diagnostic challenge as the clinical presentation is varied and usually aggressive, involving deeper penetration of pathogens resulting in ulceration or perforation of the bony areas, hence, mimicking malignancy (4). ...
... Very few fungal species like Histoplasma, Blastomyces and Chromoblastomyces causing widespread diseases in humans have been reported in literature to cause deep-seated infections of the oral cavity along with systemic involvement (3). Having said that, presented below is a case of deep mycotic infection of the oral cavity caused by a fungus that very rarely causes disease in humans, the Verticillium species. ...
Background:
Deep-seated fungal infections of the oral cavity present a diagnostic challenge as the clinical presentation is usually aggressive leading to misdiagnosis of malignancy. Nevertheless, the species of fungi responsible for such diseases in immunocompromised individuals are varied thus, further complicating the diagnosis.
Case presentation:
Presented below is a case regarding the diagnosis and management of deep mycotic infection of the oral cavity caused by a fungus that very rarely causes disease in humans, theVerticillium species.
Conclusions:
The case highlights the fact that rare pathogens should also be considered in the differential diagnosis, especially in patients with debilitating conditions like uncontrolled diabetes. Likewise, histopathological evaluation is of paramount importance and remains the gold standard to reach a definitive diagnosis.
... 16 A less common manifestation of disease seen in such patients is chronic histoplasmosis and closely resembles tuberculosis. 18 Dissemination of disease may occur during the first few weeks after acute infection. 17 Oral lesions of histoplasmosis reportedly occur in 20% to 76% of patients with progressive disseminated histoplasmosis, although they may occur in all forms of infection. ...
... 17 Oral lesions of histoplasmosis reportedly occur in 20% to 76% of patients with progressive disseminated histoplasmosis, although they may occur in all forms of infection. 14,18 These lesions present as indurated ulcers with rolled borders, similar in appearance to squamous cell carcinoma, or as nodules and granulomatous lesions of the tongue, palate, gingiva, and buccal mucosa (Figs. 5-7). ...
Oral fungal infections are opportunistic and due to impaired host resistance. The increasing number of immunosuppressed individuals contributes to rising numbers of mycoses worldwide, and the ease of global migration has allowed the geographic range of endemic mycoses to expand. Deep fungal infections can clinically mimic other pathologic conditions including malignancy. This review highlights the pathogenesis, clinical features, diagnosis, and treatment recommendations of eight fungal infections that can be encountered in the dental setting.
... En odontología son muy comunes las patologías micóticas, por lo que el odontólogo debe estar entrenado para reconocer estas en una etapa temprana, ya que muchas de las lesiones comienzan como úlceras, puntos rojos sangrantes o infiltraciones de labios y de lengua; de igual forma se pueden observar otros efectos en orofaringe y la mucosa oral en general (1) . ...
Introduction:
Paracoccidioidomycosis is an endemic mycosis in different Latin American countries, including areas of Colombia, with a very varied clinical manifestation since it is considered a disease that can be chronic and systemic.
Objectives:
To expose the importance of the clinical-stomatological examination in the detection of different entities in the stomatognathic system, and the multidisciplinary management of oral and systemic paracoccidioidomycosis.
Clinical case:
male patient in the sixth decade of life, who presented glossalgia and pain in the ocular region. Clinically, it presents a granulomatous-type lesion on the lateral edges of the tongue with evolution of approximately 1 year ago, the result of the biopsy is paracoccidioidomycosis, multidisciplinary management is started with intravenous and oral medications, after 10 months it resolves. Conclusions: a good questioning, analysis of the clinical picture and complementary tests are key to early diagnosis and timely treatment, preserving the patient's life, especially in opportunistic infections such as paracoccidioidomycosis.
... A maioria dos agentes causadores de infecção fúngica profunda apresenta predileção pelos pulmões e geralmente causa doenças respiratórias agudas ou crônicas. Acredita-se que a maioria daquelas que envolvem a cavidade oral ocorra por inoculação local ou disseminação por via hematogênica ou linfática (MUTALIK et al., 2021). ...
... Os fatores de risco geralmente associados a infecções fúngicas são imunodeficiência, uso de terapia imunossupressora ou imunomoduladora e agentes quimioterápicos. A maioria dos fungos não é capaz de causar uma infecção no hospedeiro saudável; quando causam, costumam ser assintomáticas e com resolução espontânea (MUTALIK et al., 2021). Os fungos costumam ser contraídos durante viagem ou contato com o solo ou plantas, aspectos importantes de questionamento durante a anamnese (SCULLY; ALMEIDA, 1992). ...
... O tratamento das infecções fúngicas profundas geralmente dura meses e depende da adesão do paciente para seu sucesso. Nos casos de infecções sistêmicas, os antifúngicos azólicos, como cetoconazol (MENESES-GARCÍA et al., 2002) e itraconazol (MENESES-GARCÍA et al., 2002;MUTALIK et al., 2021), são os medicamentos de escolha em função de sua relativa eficácia, segurança e facilidade de administração. A terapêutica varia de acordo com o agente etiológico específico; a anfotericina B, por exemplo, pode ser necessária em infecções mais graves. ...
[ Early Detection of Oral Cancer ]
Elaboração, distribuição e informações
MINISTÉRIO DA SAÚDE
INSTITUTO NACIONAL DE CÂNCER (INCA)
Coordenação de Prevenção e Vigilância
Divisão de Detecção Precoce e Apoio à Organização de Rede
Esta obra é disponibilizada nos termos da Licença Creative Commons – Atribuição – Não Comercial –
Compartilha igual 4.0 Internacional. É permitida a reprodução parcial ou total desta obra, desde que
citada a fonte.
Organizadores
Adriana Tavares de Moraes Atty
Caroline Madalena Ribeiro
Héliton Spindola Antunes
Renata Oliveira Maciel dos Santos
Equipe de elaboração
Adriana Tavares de Moraes Atty
Águida Aguiar Miranda
Ana Flávia Schueler de Assumpção Leite
Arn Migowski Rocha dos Santos
Caroline Madalena Ribeiro
Daniel Cohen Goldemberg
Fábio Ramôa Pires
Héliton Spindola Antunes
Juliana de Noronha Santos Netto
Luisa Aguirre Buexm
Mario José Romañach
Michelle Agostini
Renata Oliveira Maciel dos Santos
Simone de Queiroz Chaves Lourenço
Edição e produção editorial
Christine Dieguez
Copidesque
Rita Rangel de S. Machado
Revisão
Débora de Castro Barros
Capa, projeto gráfico e diagramação
Cecília Pachá
Normalização bibliográfica e ficha catalográfica
Juliana Moreira
Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//livro-diagnostico-precoce-cancer-boca-2022.pdf
... 19 Oral lesions of blastomycosis are usually ulcers or irregular erythematous swells. 21,22 Histopathologic examination usually indicates a mixture of acute inflammation with granulomas, usually noncaseating, with birefringent wall yeasts intermingled in the tissue. 19 Special stains, such as periodic acid-Schiff and Grocott-Gomori methenamine silver, can assist in the identification of the fungus. ...
... Candida was followed by Cladosporium, Aurobasidium, Saccharomyces, Aspergillus, Fusarium, and Cryptococcus, among the most common species. Four of these species, namely Candida, Aspergillus, Fusarium, and Cryptococcus, are pathogenic to immunocompromised humans when present in abundance (76)(77)(78)(79). In the oral microenvironment, C. albicans associates with Streptococcus species to promote bacterial colonization (80), and synergistic interaction between fungal-bacterial species contribute to the development of multi-microbial biofilm (81)(82)(83). ...
Mycobiota is not only associated with healthy homeostasis in the human gut but also helps to adapt to the environment. Food habits, alcohol consumption, intake of probiotics, and contaminated food with a mycotoxin, often lead to the alteration in the mycobiota composition. Impaired immunity of the host may affect fungal symbiosis leading to mycosis. The human gut adapts to the commensalism fungi belonging to the phylum Ascomycota and Basidiomycota. Diet habits such as plant-or animal-based, phytoestrogens enriched plant products, fat-rich diets also influence the colonization of certain fungal species in the mammalian gut. Food habits or mycotoxin-contaminated food or fungal peptides have an impact on bacterial-fungal interaction and human health. The mycobiota population such as Fusarium, Humicola, Aspergillus, and Candida are altered due to alcohol intake in alcoholic liver disease. The role of associated gut mycobiota due to irregular bowel habits or lifestyle change has been observed in inflammatory bowel disease. In this review, it has been observed that Saccharomyces, Aspergillus, Fusarium, Cladosporium, Candida, and Malassezia were the common genus in the human mycobiota. Therefore, this study focused on how diet habits and alcohol intake, among others., influence mycobiota composition that may affect the human immune system or overall health.
Background
Deep-seated fungal infections of the oral cavity present a diagnostic challenge as the clinical presentation is usually aggressive leading to misdiagnosis of malignancy. Nevertheless, the species of fungi responsible for such diseases in immunocompromised individuals are varied thus, further complicating the diagnosis.
Case presentation
Presented below is a case regarding the diagnosis and management of deep mycotic infection of the oral cavity caused by a fungus that very rarely causes disease in humans, the Verticillium species.
Conclusions
The case highlights the fact that rare pathogens should also be considered in the differential diagnosis, especially in patients with debilitating conditions like uncontrolled diabetes. Likewise, histopathological evaluation and microbiological investigations are of paramount importance and remain the gold standard to reach a definitive diagnosis.
