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Updated: May 19, 2026
08:22
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
An unusual cause for rings in the brain
Anulekha M John1, Natarajan Vasanthi, Abhishek Khurana
1Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|August 7, 2012
Summary
A rare case of brain and adrenal fungal infection caused by Histoplasma capsulatum in an immunocompetent man is presented. Treatment with itraconazole led to improvement, highlighting an unusual presentation of histoplasmosis.
Area of Science:
- Mycology
- Neurology
- Infectious Diseases
Background:
- Cerebral ring-enhancing lesions (CRELs) are a diagnostic challenge, often associated with tumors or other infections.
- Histoplasmosis typically affects immunocompromised individuals, presenting with varied clinical manifestations.
Observation:
- A 35-year-old immunocompetent man from North India presented with generalized tonic-clonic seizures.
- Imaging revealed ring-enhancing brain lesions and a coincident adrenal mass.
- Fungal cultures from both brain and adrenal lesions identified Histoplasma capsulatum.
Findings:
- This case highlights a rare association between cerebral ring-enhancing lesions and disseminated histoplasmosis.
- Simultaneous adrenal involvement in an immunocompetent host with neurohistoplasmosis is exceptionally uncommon.
- Successful treatment of neurohistoplasmosis and adrenal involvement was achieved with itraconazole.
Implications:
- This report expands the spectrum of clinical presentations for Histoplasma capsulatum infections.
- It underscores the importance of considering fungal etiologies, including histoplasmosis, in the differential diagnosis of CRELs, even in immunocompetent patients.
- The findings suggest that disseminated histoplasmosis can manifest with unusual patterns, necessitating a high index of suspicion for prompt diagnosis and management.
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