{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:18:44Z","timestamp":1762507124792,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,14]]},"abstract":"<jats:p>A 61-year-old female with a history of advanced HIV disease and chronic hepatitis B was presented with an 8-week history of painful oral ulcers. She appeared systemically well but examination revealed multiple well-demarcated clean-based ulcers on the tongue and hard palate. Biopsy of one of the lesions showed numerous histiocytes containing intracellular yeast forms consistent with <jats:italic>Histoplasma capsulatum var. capsulatum<\/jats:italic>. Fungal blood cultures subsequently grew <jats:italic>H. capsulatum var. capsulatum<\/jats:italic>, confirming a diagnosis of disseminated histoplasmosis. She was treated with intravenous amphotericin B for 2 weeks followed by a prolonged course of oral itraconazole, with which her ulcers resolved completely and have not recurred. This case exemplifies how oral ulcers may be a manifestation of an underlying systemic disease and demonstrates the utility of biopsy in establishing a diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2017-220364","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T07:51:08Z","timestamp":1500018668000},"page":"bcr-2017-220364","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Disseminated histoplasmosis presenting as multiple oral ulcers"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0551-7864","authenticated-orcid":false,"given":"Nicholas","family":"Hendren","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Yek","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Mull","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James B","family":"Cutrell","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,14]]},"reference":[{"key":"2025082803421831000_2017.jul14_2.bcr-2017-220364.1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.12788\/j.sder.2015.0170","article-title":"Differential diagnosis and management of oral ulcers","volume":"34","author":"Siu","year":"2015","journal-title":"Semin Cutan Med Surg"},{"key":"2025082803421831000_2017.jul14_2.bcr-2017-220364.2","unstructured":"Centers for Disease Control and Prevention. 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