Central nervous system histoplasmosis in an immunocompetent patient

Tai, Yen F.; Kullmann, Dimitri M.; Howard, Robin S.; Scott, G.M.; Hirsch, Nicholas; Révész, Tamás; Leary, Siobhan M.

doi:10.1007/s00415-010-5629-x

Cited by 11 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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: 71%

“…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: 78%

See 1 more Smart Citation

Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome

Nyalakonda

Albuerne

Hernandez

et al. 2016

The American Journal of the Medical Sciences

View full text Add to dashboard Cite

show abstract

Section: Csf Findingsmentioning

confidence: 71%

Section: Clinical Presentationmentioning

confidence: 78%

Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome

Nyalakonda

Albuerne

Hernandez

et al. 2016

The American Journal of the Medical Sciences

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…Histoplasmosis can infect multiple systems, including the central nervous system [9], articulation [6], and bone marrow, as well as nasal septum [10] and skin [11]. Occasionally it can lead to variable symptoms or even fatal outcomes, such as adrenal insufficiency induced by adrenal gland lesions [12], dysphagia induced by laryngopharyngeal nodular mass [5,13] or renal failure induced by granulomatous interstitial nephritis [14].…”

Section: Discussionmentioning

confidence: 99%

Colonic involvement in disseminated histoplasmosis of an immunocompetent adult: case report and literature review

Yang

et al. 2013

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundHistoplasmosis is a common opportunistic fungal infection that is observed almost exclusively in immunodeficient patients, especially those with AIDS. Immunocompetent individuals that suffer from histoplasmosis are rarely reported, especially those with disseminated lesions, such as disseminated histoplasmosis. The observation of disseminated histoplasmosis with prominent gastrointestinal involvement, no respiratory symptoms (which is presumed to be the portal of infection), gastrointestinal pathological changes, and minor digestive system disorders make this case study exceedingly rare.Case presentationWe report the case of a 33-year-old immunocompetent male who presented with fever and weight loss. Based on investigations, the patient showed pancytopenia, hepatosplenomegaly, bone marrow involvement and marked colonic involvement. Finally, disseminated histoplasmosis was diagnosed and confirmed by stained smears of fine needle aspirates and biopsy from lesions in the bone marrow and colon. The patient showed appreciable regression of lesions following prompt treatment with amphotericin B deoxycholate, and was treated thereafter with oral itraconazole following discharge from hospital.ConclusionDisseminated histoplasmosis could be underestimated in immunocompetent patients. A high degree of clinical suspicion is essential in both immunocompromised and immunocompetent patients, regardless of pulmonary symptoms, and whether in endemic or non-endemic areas. Early and accurate diagnosis is extremely important for the appropriate treatment of infection and to improve disease outcome.

show abstract

Central nervous system histoplasmosis in an immunocompetent patient

Cited by 11 publications

References 6 publications

Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome

Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome

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

Colonic involvement in disseminated histoplasmosis of an immunocompetent adult: case report and literature review

Contact Info

Product

Resources

About