Journal article
Disseminated histoplasmosis presenting as bilateral lower extremity paresis
International journal of infectious diseases, Vol.95, pp.265-267
06/2020
DOI: 10.1016/j.ijid.2020.03.072
PMID: 32272261
Abstract
•Disseminated histoplasmosis is a rare entity that occurs as a result of hematogenous spread of the organism within macrophages during acute infection. Risk factors for dissemination include HIV infection, being on TNF-α inhibitors, transplant recipients, and extremes of age.•Organ systems affected in disseminated histoplasmosis can be numerous and include skin, bone marrow, central nervous system, gastrointestinal tract, and adrenal glands. The differential diagnosis for adrenal insufficiency should include histoplasmosis in endemic areas.•Central nervous system histoplasmosis should be included in the differential diagnosis when a patient presents with meningitis, encephalitis, or isolated brain or spinal cord lesions in endemic areas.
Histoplasmosis is the most common endemic mycosis in the United States and is caused by the organism Histoplasma capsulatum. Infection is often asymptomatic or self-limited, but when symptomatic it usually presents in the form of pulmonary histoplasmosis. In its most severe form, H. capsulatum can spread to extrapulmonary sites causing disseminated infection. Here we present a peculiar case of central nervous system (CNS) histoplasmosis wherein multiple focal spinal cord lesions were the only manifestation of CNS infection, causing bilateral lower extremity paresis and loss of sensation. Although uncommon, CNS histoplasmosis should be included in the differential diagnosis when a patient presents with meningitis, encephalitis, or isolated brain or spinal cord lesions in endemic areas.
Details
- Title: Subtitle
- Disseminated histoplasmosis presenting as bilateral lower extremity paresis
- Creators
- Andrew Simms - University of Iowa Hospitals and ClinicsTakaaki Kobayashi - University of IowaLevi Endelman - Roy J. and Lucille A. Carver College of MedicinePoorani Sekar - University of Iowa
- Resource Type
- Journal article
- Publication Details
- International journal of infectious diseases, Vol.95, pp.265-267
- DOI
- 10.1016/j.ijid.2020.03.072
- PMID
- 32272261
- NLM abbreviation
- Int J Infect Dis
- ISSN
- 1201-9712
- eISSN
- 1878-3511
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 06/2020
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984359891602771
Metrics
13 Record Views