Lim Yan Ru^1,2*, Lum Sai Guan^2,4, Tan Mei Nee³ and Purushotman Ramasamy^1,5

¹Department of Otorhinolaryngology - Head and Neck Surgery Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
²Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
³Department of Oral and Maxillofacial Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
⁴Hospital Canselor Tuanku Muhriz, Jalan Yaakob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
⁵Otorhinolaryngology - Head & Neck Surgery Clinic, Gleneagles Hospital Penang, Malaysia

*Corresponding Author: Lim Yan Ru, Department of Otorhinolaryngology - Head and Neck Surgery Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.

Received: November 27, 2024; Published: December 03, 2024

Abstract

Invasive fungal infection is usually associated with immunocompromised patients, and its occurrence in immunocompetent patients is rare. In this case report, we present a patient who is immunocompetent and without apparent predisposing factors and was diagnosed with an invasive fungal infection from a tongue ulcer. He presented with a chronic ulcer on the tongue following an unintentional bite during a meal. Examination showed an ulcer on the left lateral border of the tongue with a rolled-out margin and indurated border, mimicking a squamous cell carcinoma. Histopathology examination from the biopsy of the tongue ulcer revealed the presence of fungal yeasts, with differential diagnosis of Candida spp., Histoplasma spp., and Cryptococcus spp. There were non necrotizing granulomas that extended deep into the muscle layer. He was treated with oral fluconazole for three months and was advised to stop smoking. He subsequently had a complete resolution of the lesion without any complications. Keywords:

Keywords:Invasive Fungal Infection; Tongue Ulcer; Immunocompetent; Antifungal Treatment

References

1. Firacative C. “Invasive fungal disease in humans: are we aware of the real impact?”. 115 (2020).
2. Ascioglu S., et al. “Defining Opportunistic Invasive Fungal Infections in Immunocompromised Patients with Cancer and Hematopoietic Stem Cell Transplants: An International Consensus”. Clinical Infectious Disease1 (2002): 7-14.
3. Fang WJ., et al. “Diagnosis of invasive fungal infections: challenges and recent developments”. Journal of Biomedical Science 30 (2023).
4. Santosh ABR., et al. “Fungal Infections of Oral Cavity: Diagnosis, Management, and Association with COVID-19”. SN Comprehensive Clinical Medicine6 (2021).
5. El MA., et al. “Fungal granuloma in immunocompetent patient masquerading as olfactory groove meningioma”. 11 (2020).
6. Loh JT and Lam K-P. “Fungal infections: Immune defense, immunotherapies and vaccines”. Advanced Drug Delivery Reviews 196 (2023).
7. Pourbaix A., et al. “Smoking as a Risk Factor of Invasive Fungal Disease: Systematic Review and Meta-Analysis”. Clinical Infectious Disease 71 (2020).
8. Mortazavi H., et al. “Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree”. International Journal of Dentistry 2016 (2016).
9. Sabino R and Wiederhold NP. “Diagnosis from Tissue: Histology and Identification”. Journal of Fungi 8 (2022).
10. Govindarajan A., et al. “Fluconazole”. StatPearls. StatPearls Publishing, Treasure Island (FL); (2023).

Citation

Citation: Lim Yan Ru., et al. “Invasive Fungal Infection of the Tongue in an Immunocompetent Patient Mimicking Squamous Cell Carcinoma". Acta Scientific Otolaryngology 7.1 (2025): 04-08.

Copyright

Copyright: © 2025 Lim Yan Ru., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.