中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (6): 413-421.DOI: 10.12337/zgkqjxjyzz.2025.06.006

• 病例报告 • 上一篇    下一篇

口腔荚膜组织胞浆菌病的诊治1例

叶小静*   

  1. 北京大学深圳医院口腔医学中心
  • 出版日期:2025-11-30 发布日期:2025-11-30
  • 通讯作者: *叶小静,联系方式:0755-83923333,电子邮箱:folamen@163.com,通讯地址:广东省深圳市福田区莲花路1120号,518000
  • 基金资助:
    深圳市口腔疾病临床医学研究中心(项目编号:20210617170745001-SCRC202201012)

A Case of Histoplasma Capsulatum and Literature Review

Xiaojing Ye*   

  1. Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, P.R. China
  • Online:2025-11-30 Published:2025-11-30
  • Contact: Xiaojing Ye. Tel: 0755-83923333. E-mail: folamen@163.com. Address: No. 1120, Lianhua Road, Futian District, Shenzhen 518000, Guangdong Province, P.R. China.
  • Supported by:
    Shenzhen Clinical Research Center for Oral Diseases (No. 20210617170745001-SCRC202201012)

摘要: 目的:报道1例发生于唇颊部及牙龈黏膜的以肉芽肿性增生为表现的荚膜组织胞浆菌病病例。诊治经过:中年男性患者出现唇颊部黏膜及牙龈糜烂及肉芽肿性增生病损数月。通过病理学检查及真菌培养,病原微生物核酸高通量测序辅助诊断为荚膜组织胞浆菌病。在排除肺部及其余器官真菌感染的前提下,制定了口服6周伊曲康唑胶囊及局部抗真菌治疗的方案。结果:治疗5周后患者牙龈及唇部肉芽肿样溃疡愈合。真菌培养阴性,达到停药标准,随访期间无复发。结论:对于持续不愈、常规治疗无效的口腔肉芽肿样溃疡,尤其是患者有真菌暴露史或存在局部免疫紊乱时,需警惕口腔荚膜组织胞浆菌病的可能。

关键词: 荚膜组织胞浆菌病, 肉芽肿性溃疡, 真菌感染, 真菌培养, 伊曲康唑

Abstract: Objective: To report a case of histoplasma capsulatum with granulomatous hyperplasia occurring in labial-buccal and gingiva mucosa. Diagnosis and Treatment: This case involves a middle-aged male patient presenting with granulomatous hyperplasia of the gingiva and labial-buccal mucosa. The diagnosis of Histoplasma capsulatum infection was confirmed by pathological examination, fungal culture, and assisted by pathogenic microorganism nucleic acid high-throughput sequencing. After excluding fungal infections of the lungs and other organs, a treatment regimen was formulated including oral itraconazole capsules for 6 weeks combined with local antifungal therapy. Results: Five weeks after treatment, the granulomatous ulcers of the patient’s gingiva and lips healed completely. Fungal culture results were negative, which met the criteria for drug withdrawal, with no recurrence during follow-up. Conclusions: For oral granulomatous ulcers that are persistent and unresponsive to conventional treatment, especially in patients with a history of fungal exposure or local immune disorders, the possibility of orofacial Histoplasma capsulatum infection should be considered.

Key words: Histoplasma capsulatum infection, granulomatous ulcer, fungal infection, fungal culture, itraconazole