Isolated Histoplasma capsulatum Meningoencephalitis in an Immunocompetent Child

Abstract

Histoplasmosis with central nervous system involvement typically arises in the immunocompromised patient with disseminated fungal disease. Rarely, neurologic histoplasmosis may arise as an isolated syndrome in immunocompetent individuals without evidence of general dissemination. The disease often is diagnostically challenging, and a high index of suspicion is required for diagnosis. We describe an immunocompetent 13-year-old girl with atypical symptoms and unusual radiologic findings due to laboratory-confirmed histoplasma meningoencephalitis. She responded well to antifungal therapy.

Histoplasmosis Brain Abscesses in an Immunocompetent Adult

“…Recently, another child in a Histoplasma endemic region was reported to have isolated histoplasma meningoencephalitis. T1 MRI demonstrated meningeal enhancement with multiple non-enhancing lesions consistent with infarction 11 . Projections into the cavity from the wall of an abscess with low apparent diffusion coefficient and no enhancement have been described as a characteristic of fungal etiology 12 .…”

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

“…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).…”

“…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.…”

Histoplasma capsulatum in New England: A Case Study

“…Interleukin-12 and interferon gamma aid the macrophages in destroying the organism. 17 Macrophages engulf the yeast and the yeast cells invade the macrophages and multiply within them. From there they are able to migrate to regional lymph nodes and then disseminate to other areas of the body hematogenously.…”