Histoplasmosis of the Periodontium - an Uncommon Condition

Histoplasmosis is caused by the fungus Histoplasma capsulatum, a dimorphic fungus that grows in the yeast form in infected tissue. The Periodontium consists of investing and supporting tissue of the tooth: gingival, periodontal ligament, cementum and alveolar bone. This report describes an unusual form of presentation of Histoplasmosis of gingiva including palate and retromolar region, which could have been mistaken as an inflammatory swelling or tubercular ulcer unless histological examination was carried out. The man was non-diabetic&Enzyme-Linked - Immunosorbent assay (ELISA) test for Human Immunodeficiency Virus was negative. During further evaluation the patient was found to have hyponatraemia and bilateral adrenal mass. He developed adrenal crisis and was managed with hydrocortisone and sodium supplementation. He has been successfully treated with Amphotericin B followed by I traconazole. Periodontal treatment includes proper brushing instruction, 0.2%, 10 ml chlorhexidine oral rinse twice daily for 30 days.