Clinical Images
Oral Ulcers with Weight Loss
A 66-year-old male presented with oral pain during eating and a 30 lb weight loss over 2 months. He resided in California but grew up near New Orleans. He last visited New Orleans 9 months before the onset of symptoms. A workup and history were negative for immunodeficiency. Exam revealed tenderness over the gingiva, base of the tongue and ulcers on the soft palate (Fig. 1). Chest x-ray was unremarkable.
Biopsy of the tongue base demonstrated non-caseating granulomas. Stainings of the tissue showed encapsulated intracellular organisms within histiocytes (Fig. 2).
