Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report

Histoplasmosis is a fungal infection caused by the fungus Histoplasma capsulatum that can rarely present with central nervous system (CNS) manifestations that include meningitis, encephalitis, focal brain or spinal cord lesions, and stroke syndromes. Because of this variation from patient to patient...

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Main Authors: Lisle Blackbourn, Elisa Yoo, Michael D. Lunt, Umair Hamid
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/crdi/1124517
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author Lisle Blackbourn
Elisa Yoo
Michael D. Lunt
Umair Hamid
author_facet Lisle Blackbourn
Elisa Yoo
Michael D. Lunt
Umair Hamid
author_sort Lisle Blackbourn
collection DOAJ
description Histoplasmosis is a fungal infection caused by the fungus Histoplasma capsulatum that can rarely present with central nervous system (CNS) manifestations that include meningitis, encephalitis, focal brain or spinal cord lesions, and stroke syndromes. Because of this variation from patient to patient, CNS histoplasmosis is a difficult clinical diagnosis to make, which can be further hindered by no highly sensitive diagnostic testing available. Here, we present a unique case of a 46-year-old male immunocompromised due to type 1 diabetes mellitus with disseminated histoplasmosis as an acute presentation of myelopathy. Patient had left leg weakness for a few days prior to presentation and a neurological exam remarkable for signs of acute thoracic myelopathy, specifically concerning for Brown-Séquard syndrome. MRI imaging demonstrated an enhancing thoracic spinal cord lesion along with multiple cerebral enhancing lesions, bilateral adrenal masses, and innumerable pulmonary nodules. Biopsy results demonstrated yeast forms consistent with Histoplasma species.
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spelling doaj-art-df449f3a462e4a2f869a596003496bb72025-08-20T02:09:24ZengWileyCase Reports in Infectious Diseases2090-66332025-01-01202510.1155/crdi/1124517Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case ReportLisle Blackbourn0Elisa Yoo1Michael D. Lunt2Umair Hamid3Department of NeurologyDepartment of Internal MedicineDepartment of PathologyNeurological InstituteHistoplasmosis is a fungal infection caused by the fungus Histoplasma capsulatum that can rarely present with central nervous system (CNS) manifestations that include meningitis, encephalitis, focal brain or spinal cord lesions, and stroke syndromes. Because of this variation from patient to patient, CNS histoplasmosis is a difficult clinical diagnosis to make, which can be further hindered by no highly sensitive diagnostic testing available. Here, we present a unique case of a 46-year-old male immunocompromised due to type 1 diabetes mellitus with disseminated histoplasmosis as an acute presentation of myelopathy. Patient had left leg weakness for a few days prior to presentation and a neurological exam remarkable for signs of acute thoracic myelopathy, specifically concerning for Brown-Séquard syndrome. MRI imaging demonstrated an enhancing thoracic spinal cord lesion along with multiple cerebral enhancing lesions, bilateral adrenal masses, and innumerable pulmonary nodules. Biopsy results demonstrated yeast forms consistent with Histoplasma species.http://dx.doi.org/10.1155/crdi/1124517
spellingShingle Lisle Blackbourn
Elisa Yoo
Michael D. Lunt
Umair Hamid
Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report
Case Reports in Infectious Diseases
title Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report
title_full Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report
title_fullStr Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report
title_full_unstemmed Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report
title_short Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report
title_sort acute myelopathy as initial presentation of disseminated histoplasmosis a case report
url http://dx.doi.org/10.1155/crdi/1124517
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