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Published on: May 26, 2023
Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report
Richard K Gurgel1, Pamela C Roehm, Marlan R Hansen
1Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Objective:
To report a unique presentation of disseminated histoplasmosis.
Study Design:
Case report.
Setting:
University hospital, tertiary referral center.
Patient:
Our patient presented with vertigo, tinnitus, and unilateral hearing loss, and was initially found to have a 5-mm enhancing left internal auditory canal mass, as revealed by a magnetic resonance imaging (MRI) scan. Subsequently, the patient developed multiple focal neurologic deficits.
Interventions:
Magnetic resonance imaging and treatment with intravenously administered amphotericin B, with subsequent oral administration of itraconazole.
Main Outcome Measures:
Clinical presentation and imaging findings of Histoplasmosis involving the cranial nerve VIII.
Results:
A subsequent MRI scan revealed enlargement of the initial lesion and multiple parenchymal lesions. Further workup revealed a pulmonary lesion; the diagnosis of disseminated histoplasmosis was made on the basis of bronchoalveolar lavage culture.
Conclusion:
Infectious processes, including disseminated histoplasmosis, should be considered in the differential of internal auditory canal masses, especially in the setting of rapid progression of symptoms.
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