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Spinal intramedullary histoplasmosis as the initial presentation of human immunodeficiency virus infection: case

Thomas C Manning1, Donald Born, Trent L Tredway

  • 1Department of Neurological Surgery, University of Washington, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104, USA. tmanning@u.washington.edu

Neurosurgery
|December 5, 2006
PubMed
Abstract

Insights

This case study highlights an extremely rare instance of spinal intramedullary histoplasmosis presenting as the first sign of human immunodeficiency virus (HIV) infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Spinal intramedullary histoplasmosis is exceptionally rare.
  • Histoplasmosis typically affects the lungs but can disseminate.

Observation:

  • A 27-year-old man presented with rapid paraparesis.
  • MRI revealed a C7-T1 intramedullary lesion with edema.
  • Initial treatment with steroids provided partial improvement.

Findings:

  • Biopsy confirmed histoplasmosis via histology, culture, and PCR.
  • The patient had no signs of disseminated disease.
  • HIV infection was diagnosed after the spinal lesion biopsy.

Implications:

  • This case demonstrates spinal histoplasmosis as an initial manifestation of HIV infection.
  • Early diagnosis and management are crucial for neurological recovery.
  • Highlights the importance of considering opportunistic infections in new-onset neurological deficits.

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