Histoplasma capsulatum Infections of the Central Nervous System

Wheat, L. Joseph; Batteiger, Byron E.; Sathapatayavongs, Boonmee

doi:10.1097/00005792-199007000-00006

Cited by 190 publications

(203 citation statements)

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“…Patients can have involvement of the central nervous system (CNS) either as one manifestation of a disseminated infection or as an isolated focal infection (145,157). CNS involvement occurs as a result of hematogenous dissemination to the meninges or brain.…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

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Histoplasmosis: a Clinical and Laboratory Update

2007

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SUMMARY Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

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Section: Disseminated Histoplasmosismentioning

confidence: 99%

“…One unique circumstance in which the presence of antibodies may be the only assay leading to a diagnosis of histoplas- (128,145).…”

Section: Antibody Testsmentioning

confidence: 99%

Histoplasmosis: a Clinical and Laboratory Update

2007

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“…However, in areas where Histoplasma is endemic, these lesions are generally well recognised and are unlikely to be confused with malignancy, particularly when tell-tale calcifications are present [3]. Mass lesions caused by Histoplasma infection may also occur in the central nervous system, including the spinal cord, and here can radiologically simulate a neoplasm [4][5][6][7]. Diffuse enlargement of the adrenal glands without a definable mass is not uncommon in Histoplasma infection [8].…”

Section: Discussionmentioning

confidence: 99%

Histoplasma-associated inflammatory pseudotumour of the kidney mimicking renal carcinoma

et al. 2009

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A 56-year-old female, originally from Suriname, with an otherwise unremarkable previous medical history was found to have a renal mass highly suspicious for renal cancer for which a nephrectomy was performed. Within the kidney, a tumourous mass was found which, on histological examination, showed an inflammatory pseudotumour caused by Histoplasma capsulatum. Further investigations revealed an idiopathic CD4 + lymphopenia. Mass lesions mimicking a malignant tumour caused by infection with Histoplasma have rarely been described. To the best of our knowledge, this is the first report of a Histoplasmaassociated inflammatory pseudotumour mimicking cancer occurring in the kidney

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“…Entre el 25 y el 50 % de los pacientes con histoplasmosis pueden presentar síntomas del sistema nervioso central (6,8). Como sería de esperarse, en un tercio de los enfermos con este tipo de histoplasmosis, otros órganos y sistemas, como el bazo, el hígado y las mucosas, también se ven afectados.…”

Section: Histoplasmosis Del Sistema Nervioso Centralunclassified

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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Histoplasma capsulatum Infections of the Central Nervous System

Cited by 190 publications

References 0 publications

Histoplasmosis: a Clinical and Laboratory Update

Histoplasmosis: a Clinical and Laboratory Update

Histoplasma-associated inflammatory pseudotumour of the kidney mimicking renal carcinoma

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

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