HISTOPLASMOSE DISSEMINADA COM MANIFESTAÇÃO ORAL EM PACIENTE COM DOENÇA DE CROHN
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Publicado:
Out 29, 2024
Palavras-chave:
Histoplasmose;, Infecção fúngica disseminada, Doenças bucais, Doença Autoimune, Doença de Crohn
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Resumo
A Histoplasmose e a Doença de Crohn (DC) são enfermidades que podem se assemelhar em características clínicas e, assim, dificultar o diagnóstico por parte do médico ou cirurgião-dentista. O objetivo deste trabalho é demonstrar, através de um caso clínico, o desafio diagnóstico de uma lesão única de histoplasmose na cavidade oral em paciente com doença crônica granulomatosa. No exame histopatológico, verificou tratar-se de lesão oral decorrente de processo granulomatoso específico, diagnosticado em seguida como histoplasmose mediante cultura. A avaliação médica sistêmica não identificou lesões compatíveis com histoplasmose em outros órgãos. Após terapia apropriada, houve a remissão da infecção fúngica e o seguimento terapêutico da doença autoimune. A co-ocorrência de histoplasmose em pacientes com DC é uma possibilidade a ser considerada, especialmente em virtude do potencial estado de imunossupressão associado a essa condição. Este caso demonstrou que, embora o exame anatomopatológico possa não detectar o microrganismo na amostra de tecido, a cultura microbiológica deve ser considerada um exame complementar essencial para o diagnóstico de micoses profundas.
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Como Citar
Fossalussa da Silva, C., Angélica de Paiva Paula, C., Borba Carneiro, T., Mota Loyola, A., & César Guimarães Henriques, J. (2024). HISTOPLASMOSE DISSEMINADA COM MANIFESTAÇÃO ORAL EM PACIENTE COM DOENÇA DE CROHN. Revista Naval De Odontologia, 51(2), 43-49. https://doi.org/10.69909/1983-7550-histoplasmose-5
Seção
Relatos de caso
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Referências
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4. Baumgart DC, Sandborn WJ. Crohn’s disease. Lancet. 2012;380:1590-605.
5. Thrash B, Patel M, Shah KR, Boland CR, Menter A. Cutaneous Manifestations of Gastrointestinal Disease:Part II. J Am Acad Dermatol. 2013;68:244-6.
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7. Rothfuss KS, Stange EF, Herrlinger KR. Extraintestinal manifestations and complications in inflammatory bowel diseases. World J Gastroenterol. 2006;14(12):4819-31.
8. Strober W, Fuss I, Kitani A. Regulation of experimental mucosal inflammation. Acta Odontol Scand. 2001;59:244-7.
9. Dupuy A, Cosnes J, Revuz J, Delchier JC, Gendre JP, Cosnes A. Longterm evolution of oral localisation of Crohn’s disease. Gastroenterology. 1998;114:A956.
10. Cosnes J, Nion-Larmurier I, Afchain P, Beaugerie L, Gendre J-P.Gender differences in the response of colitis to smoking. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2004;2:41-8.
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13. Hussey S, Fleming P, Rowland M, Harty S, Chan L, Broderick A, et al. Disease outcome for children who present with oral manifestations of Crohn’s disease. Eur Arch Paediatr Dent. 2011;12(3):167-9.
14. Sanderson J, Nunes C, Escudier M, Barnard K, Shirlaw P, Odell E, et al. Oro-facial granulomatosis: Crohn’s disease or a new inflammatory bowel disease?. Inflamm Bowel Dis. 2005;11:840-6.
15. Kolho KL, Ainamo A. Progress in the treatment and outcome of pediatric inflammatory bowel disease patients. Expert Rev Clin Immunol. 2016 Dec;12(12):1337-45.
16. Litsas G. Crohn’s disease of the mouth: report of a case. Eur J Paediatr Dent 2011;12:1-3.
17. Jajam M, Bozzolo P, Niklander S. Oral manifestations of gastrointestinal disorders. J Clin Exp Dent. 2017;10:1242-8.
18. Rezaie A, Kuenzig ME, Benchimol EI, Griffiths AM, Otley AR, Steinhart H, et al. Budesonide for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2015;6:CD000296.
19. Pittock S, Drumm B, Fleming P, McDermott M, Imrie C, Flint S, et al. The oral cavity in Crohn’s disease. J Pediatr. 2001;138:767-71.
20. Triantafillidis JK, Valvi FZ, Merikas E, Peros G, Galitis ON, Gikas A. Granulomatous cheilitis associated with exacerbations of Crohn’s disease: a case report. J Med Case Rep. 2008 Feb 25;2:60.
21. Thia KT, Sandborn WJ, Harmsen WS, Zinsmeister AR, Loftus EV. Risk factors associated with progression to intestinal complications of Crohn’s disease in a populationbased cohort. Gastroenterology. 2010;139:1147-55.
22. William T, Marsch WC, Schmidt F, Kreft B. Early oral presentation of Crohn’s disease. JDDG. 2007;5:678-9.
23. Eckel A, Lee D, Deutsch G, Maxin A, Oda D. Oral manifestations as the first presenting sign of Crohn’s disease in a pediatric patient. J Clin Exp Dent. 2017 Jul 1;9(7):e934-e938.
24. Gundacker ND, Rolfe RJ, Rodriguez JM. Infections associated with adventure travel: a systematic review. Trav Med Infect Dis. 2017;16:3-10.
25. Akran SM, Koirala J. Histoplasmosis. Treasure Island; 2023.
26. Heninger E, Hogan LH, Karman J, Macvilay S, Hill B, Woods JP, et al. Characterization of the Histoplasma capsulatuminduced granuloma. J Immunol. 2006;177(5):3303-13.
27. Azar MM, Hage CA. Laboratory diagnostics for histoplasmosis. J Clin Microbiol. 2017;55(6):1612-20.
28. Skrzat A, Kowalczyk DO, Szybka AT. Crohn’s disease should be considered in children with inflammatory oral lesions. Acta Paediatr. 2016;106:199-203.
29. Falci DR, Monteiro AA, Braz CFC, Magalhães TCO, Xavier MO, Basso RP, et al. Histoplasmosis, na underdiagnosed disease affecting people living with HIV/AIDS in Brazil: results of a multicenter prospective cohort study using both classical mycology testes and Histoplasma Urine Antigen Detection. Open Forum Infect Dis. 2019;6(4):ofz073.
30. Mignogna MD, Fedele S, Lo Russo L, Ruoppo E, Lo Muzio L. A case of oral localized histoplasmosis in an immunocompetent patient. Eur J Clin Microbiol Infect Dis. 2001;20(10):753-5.
2. Jianzhong H. The genetic predisposition and the interplay of host genetics and gut microbiome in Crohn disease. Clin Lab Med. 2014;34:763-70.
3. Oghan F, Pekkan G, Ozveren O. Saddle nose deformity, palatalperforation and truncus arteriosus in a patient with Crohn’s disease. Craniomaxillofac Surg. 2012 Jan;40(1):17-9.
4. Baumgart DC, Sandborn WJ. Crohn’s disease. Lancet. 2012;380:1590-605.
5. Thrash B, Patel M, Shah KR, Boland CR, Menter A. Cutaneous Manifestations of Gastrointestinal Disease:Part II. J Am Acad Dermatol. 2013;68:244-6.
6. Tan CX, Brand HS, de Boer NK, Forouzanfar T. Gastrointestinal diseases and their oro-dental manifestations: Part 1: Crohn’s disease. Br Dent J. 2016 Dec 16;221(12):794-9.
7. Rothfuss KS, Stange EF, Herrlinger KR. Extraintestinal manifestations and complications in inflammatory bowel diseases. World J Gastroenterol. 2006;14(12):4819-31.
8. Strober W, Fuss I, Kitani A. Regulation of experimental mucosal inflammation. Acta Odontol Scand. 2001;59:244-7.
9. Dupuy A, Cosnes J, Revuz J, Delchier JC, Gendre JP, Cosnes A. Longterm evolution of oral localisation of Crohn’s disease. Gastroenterology. 1998;114:A956.
10. Cosnes J, Nion-Larmurier I, Afchain P, Beaugerie L, Gendre J-P.Gender differences in the response of colitis to smoking. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2004;2:41-8.
11. Loddo I, Romano C. Inflammatory bowel disease: Genetics, epigenetics, and pathogenesis. Front Immunol. 2015;6:6-11.
12. Zhao XS, Wang ZT, Wu ZY, Yin QH, Zhong J, Miao F, et al. Differentiation of Crohn’s disease from intestinal tuberculosis by clinical and CT enterographic models. Inflamm Bowel Dis. 2014;20:916-25.
13. Hussey S, Fleming P, Rowland M, Harty S, Chan L, Broderick A, et al. Disease outcome for children who present with oral manifestations of Crohn’s disease. Eur Arch Paediatr Dent. 2011;12(3):167-9.
14. Sanderson J, Nunes C, Escudier M, Barnard K, Shirlaw P, Odell E, et al. Oro-facial granulomatosis: Crohn’s disease or a new inflammatory bowel disease?. Inflamm Bowel Dis. 2005;11:840-6.
15. Kolho KL, Ainamo A. Progress in the treatment and outcome of pediatric inflammatory bowel disease patients. Expert Rev Clin Immunol. 2016 Dec;12(12):1337-45.
16. Litsas G. Crohn’s disease of the mouth: report of a case. Eur J Paediatr Dent 2011;12:1-3.
17. Jajam M, Bozzolo P, Niklander S. Oral manifestations of gastrointestinal disorders. J Clin Exp Dent. 2017;10:1242-8.
18. Rezaie A, Kuenzig ME, Benchimol EI, Griffiths AM, Otley AR, Steinhart H, et al. Budesonide for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2015;6:CD000296.
19. Pittock S, Drumm B, Fleming P, McDermott M, Imrie C, Flint S, et al. The oral cavity in Crohn’s disease. J Pediatr. 2001;138:767-71.
20. Triantafillidis JK, Valvi FZ, Merikas E, Peros G, Galitis ON, Gikas A. Granulomatous cheilitis associated with exacerbations of Crohn’s disease: a case report. J Med Case Rep. 2008 Feb 25;2:60.
21. Thia KT, Sandborn WJ, Harmsen WS, Zinsmeister AR, Loftus EV. Risk factors associated with progression to intestinal complications of Crohn’s disease in a populationbased cohort. Gastroenterology. 2010;139:1147-55.
22. William T, Marsch WC, Schmidt F, Kreft B. Early oral presentation of Crohn’s disease. JDDG. 2007;5:678-9.
23. Eckel A, Lee D, Deutsch G, Maxin A, Oda D. Oral manifestations as the first presenting sign of Crohn’s disease in a pediatric patient. J Clin Exp Dent. 2017 Jul 1;9(7):e934-e938.
24. Gundacker ND, Rolfe RJ, Rodriguez JM. Infections associated with adventure travel: a systematic review. Trav Med Infect Dis. 2017;16:3-10.
25. Akran SM, Koirala J. Histoplasmosis. Treasure Island; 2023.
26. Heninger E, Hogan LH, Karman J, Macvilay S, Hill B, Woods JP, et al. Characterization of the Histoplasma capsulatuminduced granuloma. J Immunol. 2006;177(5):3303-13.
27. Azar MM, Hage CA. Laboratory diagnostics for histoplasmosis. J Clin Microbiol. 2017;55(6):1612-20.
28. Skrzat A, Kowalczyk DO, Szybka AT. Crohn’s disease should be considered in children with inflammatory oral lesions. Acta Paediatr. 2016;106:199-203.
29. Falci DR, Monteiro AA, Braz CFC, Magalhães TCO, Xavier MO, Basso RP, et al. Histoplasmosis, na underdiagnosed disease affecting people living with HIV/AIDS in Brazil: results of a multicenter prospective cohort study using both classical mycology testes and Histoplasma Urine Antigen Detection. Open Forum Infect Dis. 2019;6(4):ofz073.
30. Mignogna MD, Fedele S, Lo Russo L, Ruoppo E, Lo Muzio L. A case of oral localized histoplasmosis in an immunocompetent patient. Eur J Clin Microbiol Infect Dis. 2001;20(10):753-5.