Ischemic brain infarcts and vasculitis in histoplasmosis of the central nervous system: A case report and review of the literature.
Acquired immunodeficiency syndrome
Central nervous system
Fungal lung diseases
HIV
Lacunar stroke
Mycoses
Stroke
Vasculitis
Journal
IDCases
ISSN: 2214-2509
Titre abrégé: IDCases
Pays: Netherlands
ID NLM: 101634540
Informations de publication
Date de publication:
2021
2021
Historique:
received:
16
08
2021
revised:
16
11
2021
accepted:
16
11
2021
entrez:
8
12
2021
pubmed:
9
12
2021
medline:
9
12
2021
Statut:
epublish
Résumé
Histoplasmosis is one of the most common endemic mycoses affecting immunocompromised individuals in the United States and Latin America. Involvement of the central nervous system carries higher mortality rates and worse prognosis, given its resemblance to stroke, vasculitis, and meningitis of other etiologies. The diagnosis is challenging, due to its subtle clinical presentation and the poor sensitivity of the cerebrospinal fluid culture. Herein the authors present a case of a middle-aged man with HIV, who presented with intermittent headaches exacerbated by an oculomotor nerve palsy, concerning for acute stroke. A diagnosis of central nervous system histoplasmosis was made, and his neurological deficits subsided after initiation of treatment. The stroke-like syndrome in this scenario may be secondary to granulomatous vasculitis of small caliber cerebral blood vessels. Histoplasmosis of the central nervous system remains a challenging diagnosis, which requires a high index of suspicion by the clinician for an early institution of therapy in order to improve outcomes.
Identifiants
pubmed: 34877258
doi: 10.1016/j.idcr.2021.e01347
pii: S2214-2509(21)00303-6
pmc: PMC8627974
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e01347Informations de copyright
Published by Elsevier Ltd.
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