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Related Experiment Videos

[Spinal cord histoplasmoma. A case report].

M Rivierez1, D Heyman, A Brebion

  • 1Service de Neurochirurgie, Hospital P. Zobda-Quitman, CHU, 97200 Fort-de-France. maurice.rivierez@wanadoo.fr

Neuro-Chirurgie
|April 25, 2002
PubMed
Summary

A rare case of disseminated histoplasmosis caused severe neurological symptoms, including paraplegia and cognitive decline, in an immunocompetent patient. Early antifungal treatment improved brain lesions but not spinal cord deficits.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Disseminated histoplasmosis is typically associated with immunodeficiency.
  • Central nervous system (CNS) involvement, particularly spinal cord histoplasmomas, is exceptionally rare.

Observation:

  • A 60-year-old chicken breeder presented with progressive paraplegia, sphincter impairment, and cognitive dysfunction.
  • MRI revealed conus medullaris enlargement and brain lesions.
  • Biopsies confirmed Histoplasma capsulatum (Hc) infection, with positive HTLV1 antibodies but no immunodeficiency.

Findings:

  • Intravenous amphotericin B followed by oral itraconazole treatment led to significant cognitive improvement within 5 weeks.
  • Cerebral lesions and spinal cord edema resolved over 7 months.

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  • Paraplegia and sphincter dysfunction showed no improvement.

    • Implications:

    • This case highlights a rare instance of CNS histoplasmosis in an immunocompetent individual.
    • It underscores the potential for severe neurological deficits despite effective antifungal therapy.
    • The findings emphasize the diagnostic challenge and varied prognosis of spinal cord histoplasmomas.