Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System

Background. Histoplasmosis is a common fungal infection in the southeastern, mid-Atlantic, and central states; however, its presentation can be atypical. Case Presentation. We report a case of Histoplasma capsulatum infection presenting as slowly progressive weakness in the lower extremities, follow...

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Main Authors: Albert J. Eid, John D. Leever, Kathrin Husmann
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2015/581415
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author Albert J. Eid
John D. Leever
Kathrin Husmann
author_facet Albert J. Eid
John D. Leever
Kathrin Husmann
author_sort Albert J. Eid
collection DOAJ
description Background. Histoplasmosis is a common fungal infection in the southeastern, mid-Atlantic, and central states; however, its presentation can be atypical. Case Presentation. We report a case of Histoplasma capsulatum infection presenting as slowly progressive weakness in the lower extremities, followed by the development of numbness below the midthoracic area, urinary incontinence, and slurred speech. Brain MRI showed leptomeningeal enhancement, predominantly linear, involving the basal cisterns, the brainstem, and spinal cord. Cerebrospinal fluid analysis showed lymphocytic pleocytosis. Discussion. CNS histoplasmosis is usually seen in patients with disseminated histoplasmosis. Isolated CNS histoplasmosis is rarely seen, especially in immunocompetent patients. Conclusions. Histoplasmosis should be considered in the differential diagnosis of patients experiencing slowly progressive neurological deficit.
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spelling doaj-art-e56a73b722404bf28a32d76a059dfbb82025-08-20T02:21:19ZengWileyCase Reports in Infectious Diseases2090-66252090-66332015-01-01201510.1155/2015/581415581415Compartmentalized Histoplasma capsulatum Infection of the Central Nervous SystemAlbert J. Eid0John D. Leever1Kathrin Husmann2Division of Infectious Diseases, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USADepartment of Radiology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USADepartment of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USABackground. Histoplasmosis is a common fungal infection in the southeastern, mid-Atlantic, and central states; however, its presentation can be atypical. Case Presentation. We report a case of Histoplasma capsulatum infection presenting as slowly progressive weakness in the lower extremities, followed by the development of numbness below the midthoracic area, urinary incontinence, and slurred speech. Brain MRI showed leptomeningeal enhancement, predominantly linear, involving the basal cisterns, the brainstem, and spinal cord. Cerebrospinal fluid analysis showed lymphocytic pleocytosis. Discussion. CNS histoplasmosis is usually seen in patients with disseminated histoplasmosis. Isolated CNS histoplasmosis is rarely seen, especially in immunocompetent patients. Conclusions. Histoplasmosis should be considered in the differential diagnosis of patients experiencing slowly progressive neurological deficit.http://dx.doi.org/10.1155/2015/581415
spellingShingle Albert J. Eid
John D. Leever
Kathrin Husmann
Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
Case Reports in Infectious Diseases
title Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
title_full Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
title_fullStr Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
title_full_unstemmed Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
title_short Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
title_sort compartmentalized histoplasma capsulatum infection of the central nervous system
url http://dx.doi.org/10.1155/2015/581415
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AT johndleever compartmentalizedhistoplasmacapsulatuminfectionofthecentralnervoussystem
AT kathrinhusmann compartmentalizedhistoplasmacapsulatuminfectionofthecentralnervoussystem