Infection with Histoplasma capsulatum can produce a broad range of clinical diseases and may involve varied organ systems via lymphatics and the bloodstream, similar to the situation with tuberculosis. Clinical presentations in patient with AIDS with disseminated histoplasmosis include fever, respiratory symptoms, weight loss, diarrhea, malaise, anorexia, hepatosplenomegaly, and lymphadenopathy [1, 2]. Oral involvement is relatively rare, but when a mucocutaneous lesion (Figure 1) is found, the clinical physician should consider it as a manifestation of systemic infection [2].

The epidemiological data of histoplasmosis in Taiwan were scarce, and there was only a national survey of histoplasmin skin tests in the 1950s, revealing that 7 (0.19%) of 3589 school children had a positive reaction [3]. However, the first case in Taiwan was not reported until 1997, and since then, only a limited number of cases have been described. Only 3 cases of