Meningoencephalitis caused by Histoplasma capsulatum complicating pregnancy

McGregor, James A.; Kleinschmidt‐DeMasters, Bette K.; Ogle, John W.

doi:10.1016/0002-9378(86)90488-6

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…We found 1159 studies and included 108 manuscripts published between 1962 and 2022, totaling 298 patients 7–10,12–115 . We excluded 38 articles that could not be retrieved.…”

Section: Resultsmentioning

confidence: 99%

“…Hydrocephalus was typically communicating, although there was one case with an intraventricular lesion 64 . Vasculitis more commonly presented as a small‐vessel disease, 29,33,35,63 particularly in the basal ganglia and brainstem, although cases of large‐vessel disease were also described 46,72 …”

Section: Resultsmentioning

confidence: 99%

“…64 Vasculitis more commonly presented as a small-vessel disease, 29,33,35,63 particularly in the basal ganglia and brainstem, although cases of large-vessel disease were also described. 46,72…”

Section: Radiological Characteristicsmentioning

confidence: 99%

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Clinical, radiological and laboratory characteristics of central nervous system histoplasmosis: A systematic review of a severe disease

Oliveira

Kruschewsky

Sekiguchi

et al. 2023

Mycoses

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Background:The knowledge of central nervous system (CNS) histoplasmosis is limited to case reports and series.Objectives: Our objective was to synthesise clinical, radiological and laboratory characteristics of CNS histoplasmosis to improve our understanding of this rare disease. Methods:We performed a systematic review using Pubmed/MEDLINE, Embase and LILACS databases accessed on March 2023 without publication date restrictions.Inclusion criteria comprised: (1) histopathological, microbiological, antigen or serological evidence of histoplasmosis; (2) CNS involvement based on cerebrospinal fluid pleocytosis or neuroimaging abnormalities. We classified the certainty of the diagnosis in proven (CNS microbiological and histopathological confirmation), probable (CNS serological and antigen confirmation) or possible (non-CNS evidence of histoplasmosis). Metaproportion was used to provide a summary measure with 95% confidence intervals for the clinical, radiological and laboratory characteristics. Chi-squared test was used to compare mortality between pairs of antifungal drugs. Results:We included 108 studies with 298 patients. The median age was 31 years, predominantly male, and only 23% were immunocompromised (134/276, 95%CI: 3-71), mainly due to HIV infection. The most common CNS symptom was headache (130/236, 55%, 95%CI: 49-61), with a duration predominantly of weeks or months.Radiological presentation included histoplasmoma (79/185, 34%, 95%CI: 14-61), meningitis (29/185, 14%, 95%CI: 7-25), hydrocephalus (41/185, 37%, 95%CI: 7-83) and vasculitis (18/185, 6%, 95%CI: 1-22). There were 124 proven cases, 112 probable cases and 40 possible cases. The majority of patients presented positive results in CNS pathology (90%), serology (CSF: 72%; serum: 70%) or CSF antigen (74%). Mortality was high (28%, 56/198), but lower in patients who used liposomal amphotericin B and itraconazole. Relapse occurred in 13% (23/179), particularly in HIV patients, but less frequently in patients who used itraconazole. Conclusion:Central nervous system histoplasmosis usually presents subacute-tochronic symptoms in young adults. Neuroimaging patterns included not only focal lesions but also hydrocephalus, meningitis and vasculitis. Positive results were

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“…We found 1159 studies and included 108 manuscripts published between 1962 and 2022, totaling 298 patients 7–10,12–115 . We excluded 38 articles that could not be retrieved.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical, radiological and laboratory characteristics of central nervous system histoplasmosis: A systematic review of a severe disease

Oliveira

Kruschewsky

Sekiguchi

et al. 2023

Mycoses

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“…In a cerebrovascular event observed as a complication of histoplasmosis meningoencephalitis, small leptomeningeal vessels had mononuclear cell infiltration of outer vessel walls and early reactive intimal proliferation on hematoxylin and eosin staining on cross sections. 21 Epithelioid cells, and histiocytic and rare giant cell infiltration, have also been observed below the meningeal vein intima. 22 Several studies have assessed serologic markers of Chlamydia pneumoniae to support a link to stroke.…”

Section: Discussionmentioning

confidence: 96%

Association Between Histoplasma Exposure and Stroke

Cleary

Pearson

Oliver

et al. 2008

Journal of Stroke and Cerebrovascular Diseases

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Histoplasmosis in Pregnancy

Whitt¹,

Koch²,

Fender³

et al. 2004

Arch Intern Med

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Although a healthy pregnancy seems to confer an increased susceptibility to systemic fungal infections, to our knowledge, no known association exists in the case of Histoplasma capsulatum. In addition, to our knowledge, transplacental transmission of H capsulatum has not been previously described. We describe a series of patients treated at our institutions between 1997 and 2000 with evidence of transplacental transmission of H capsulatum. Mechanisms of increased risk of histoplasmosis during pregnancy are proposed, although this risk has yet to be proved.

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Meningoencephalitis caused by Histoplasma capsulatum complicating pregnancy

Cited by 6 publications

References 10 publications

Clinical, radiological and laboratory characteristics of central nervous system histoplasmosis: A systematic review of a severe disease

Clinical, radiological and laboratory characteristics of central nervous system histoplasmosis: A systematic review of a severe disease

Association Between Histoplasma Exposure and Stroke

Histoplasmosis in Pregnancy

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