Clinical and Laboratory Diagnosis of Central Nervous System Histoplasmosis

Ranganath, Sangeetha; McGhie, Travea; LaRosa, Steven P.; Lehman, W. B.; Fader, Robert

doi:10.1016/j.amjmed.2011.12.011

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…Non-HIV immunosuppressed and immunocompetent cases that underwent CSF analysis had pleocytosis, elevated protein and hypoglycorrhachia [13][14][15][16][20][21][22][23][24] as did the AIDS cases from our institution. CSF pleocytosis with lymphocytic predominance was seen even in cases with very low-peripheral leukocyte or CD4 counts.…”

Section: Csf Findingsmentioning

confidence: 72%

“…Mental status changes and focal neurological signs were also prominent, although cranial neuropathies and seizures were less commonly seen. 3,13,[17][18][19][20][21][22][23][24][25] This experience shows that the clinical presentation of CNS histoplasmosis is nonspecific and may mimic other more common etiologies such as cryptococcal or tuberculous meningitis. 4,5 Diagnosis is particularly difficult in cases presenting with isolated CNS involvement and no other clinical or laboratory evidence of disseminated infection.…”

Section: Clinical Presentationmentioning

confidence: 77%

“…[3][4][5][6][8][9][10][11][12][13] Hydrocephalus was found in immunocompetent patients many of whom had ventriculoperitoneal shunts in place at time of diagnosis. 13,[17][18][19][20][21][22][23][24][25] This was likely caused by histoplasmosis. In non-HIV immunosuppressed patients, masses and hydrocephalus were equally prevalent.…”

Section: Neuroimaging Findingsmentioning

confidence: 99%

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Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome

Nyalakonda

Albuerne

Hernandez

et al. 2016

The American Journal of the Medical Sciences

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Section: Csf Findingsmentioning

confidence: 72%

Section: Clinical Presentationmentioning

confidence: 77%

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Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome

Nyalakonda

Albuerne

Hernandez

et al. 2016

The American Journal of the Medical Sciences

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“…En la literatura científica mundial existen pocos reportes de histoplasmosis del sistema nervioso central en personas inmunocompetentes, y tan solo un pequeño porcentaje de los casos corresponde a pacientes pediátricos (17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionunclassified

“…Los síntomas pueden ser muy variados y, como sucedió en este caso, suele haber un retraso de varias semanas o meses en el diagnóstico; por ello, los médicos en regiones endémicas siempre deben contemplar y sospechar la presencia de histoplasmosis como un diagnóstico diferencial en pacientes con sintomatología insidiosa del sistema nervioso central y en aquellos con hidrocefalia obstructiva cuyo origen sea difícil de establecer (17)(18)(19)(20)(21)(22)(23). Por su localización geográfica y por presentar las condiciones ambientales óptimas para el hongo (temperatura, composición del suelo, humedad, etc.…”

Section: Discussionunclassified

Histoplasmosis diseminada progresiva con afectación del sistema nervioso central en un paciente inmunocompetente. Presentación de un caso y revisión de la literatura

2014

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La histoplasmosis es una afección polifacética producida por el hongo dimorfo Histoplasma capsulatum, cuyas esporas son inhaladas y llegan al pulmón, órgano primario de infección. La forma meníngea, considerada como una de las manifestaciones más graves de esta micosis, suele presentarse en individuos con alteraciones en la inmunidad celular: pacientes con síndrome de inmunodeficiencia humana adquirida, con lupus eritematoso sistémico o con trasplante de órgano sólido, así como en lactantes, debido a su inmadurez inmunológica. La forma de presentación más usual es de resolución espontánea y se observa en individuos inmunocompetentes que se han expuesto a altas concentraciones de conidias y fragmentos miceliares del hongo. En estas personas, la afección se manifiesta por trastornos pulmonares y por la posterior diseminación a otros órganos y sistemas. Se presenta un caso de histoplasmosis del sistema nervioso central en un niño inmunocompetente. Histoplasmosis of the central nervous system in an immunocompetent patientHistoplasmosis is a multifaceted condition caused by the dimorphic fungi Histoplasma capsulatum whose infective spores are inhaled and reach the lungs, the primary organ of infection. The meningeal form, considered one of the most serious manifestations of this mycosis, is usually seen in individuals with impaired cellular immunity such as patients with acquired immunodeficiency syndrome, systemic lupus erythematous or solid organ transplantation, and infants given their immunological immaturity. The most common presentation is self-limited and occurs in immunocompetent individuals who have been exposed to high concentrations of conidia and mycelia fragments of the fungi. In those people, the condition is manifested by pulmonary disorders and late dissemination to other organs and systems. We report a case of central nervous system histoplasmosis in an immunocompetent child.

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