Presentación clínica e histopatológica de la histoplasmosis en la cavidad oral: una revisión sistemática
Resumen
Objetivo: Las lesiones orales pueden ser un indicador temprano de histoplasmosis sistémica, especialmente en pacientes inmunodeprimidos. El objetivo principal de esta revisión fue resumir los hallazgos demográficos y clínicos y correlacionarlos con los hallazgos histopatológicos.
Material y métodos: La búsqueda bibliográfica incluyó artículos publicados sobre histoplasmosis oral en bases de datos como PubMed, Scopus, Web of Science y EMBASE. Los artículos incluidos proporcionaron información sobre datos sociodemográficos y clínicos, el estado de infección por el virus de la inmunodeficiencia humana (VIH), las características histopatológicas, el tratamiento y el pronóstico. Esta revisión incluyó 30 informes de casos que abarcaban un total de 92 casos individuales, de los cuales 34 eran VIH positivos.
Resultados: La manifestación oral se observó como una forma diseminada en todos los pacientes con VIH. La histoplasmosis oral se presenta clínicamente como una lesión ulcerada dolorosa que se observa comúnmente en la lengua, la encía, el paladar y la mucosa bucal. Histopatológicamente, se observaron láminas de histiocitos con células levaduriformes, infiltrado inflamatorio y células gigantes multinucleadas. Los hallazgos histopatológicos son esenciales para el diagnóstico precoz de la histoplasmosis oral, ya que podría simular clínicamente otras enfermedades. El itraconazol demostró ser un tratamiento eficaz para la histoplasmosis oral.
Conclusiones: Las lesiones orales de histoplasmosis pueden presentarse en países no endémicos y en personas inmunocompetentes. Los hallazgos histopatológicos son esenciales para el diagnóstico precoz de la histoplasmosis oral, ya que podría simular clínicamente otras enfermedades.
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