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Chronic primary central nervous system histoplasmosis in a healthy child with intermittent neurological

Jennifer E Schuster1, Curtis A Wushensky, M Cecilia Di Pentima

  • 1Department of Pediatrics, Infectious Diseases Division, Vanderbilt University, Nashville, TN 37232, USA.

The Pediatric Infectious Disease Journal
|July 11, 2013
PubMed

Insights

Meningitis caused by Histoplasma capsulatum is rare in healthy children. This case highlights chronic fungal meningitis mimicking demyelinating disease in a previously healthy boy.

Area of Science:

  • Pediatric Infectious Diseases
  • Neuroimmunology
  • Mycology

Background:

  • Histoplasma capsulatum is a fungus endemic to certain regions, typically causing pulmonary infections.
  • Meningitis is an uncommon presentation, especially in immunocompetent individuals.
  • Demyelinating diseases in children often present with varied neurological symptoms.

Observation:

  • A previously healthy 6-year-old boy presented with a 7-month history of intermittent neurological symptoms.
  • Cerebrospinal fluid analysis and imaging were crucial for diagnosis.
  • Magnetic resonance imaging (MRI) revealed findings suggestive of demyelination.

Findings:

  • The patient was diagnosed with primary, chronic meningitis due to Histoplasma capsulatum.
  • The fungal infection mimicked the clinical and radiological features of a demyelinating disorder.
  • This case underscores the importance of considering fungal infections in unexplained neurological conditions.

Implications:

  • This case expands the understanding of Histoplasma capsulatum's neurological manifestations in children.
  • It emphasizes the need for a broad differential diagnosis in pediatric neurological cases.
  • Early recognition and treatment are vital for favorable outcomes in pediatric fungal meningitis.

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