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Central Nervous System Infection with Histoplasma capsulatum
James Riddell1, L Joseph Wheat2
1Division of Infectious Diseases, University of Michigan Health System, 1500 E. Medical Center Drive, University Hospital South F4131, Ann Arbor, MI 48109, USA. jriddell@umich.edu.
Abstract:
Histoplasmosis is an endemic fungal infection that may affect both immune compromised and non-immune compromised individuals. It is now recognized that the geographic range of this organism is larger than previously understood, placing more people at risk. Infection with Histoplasma capsulatum may occur after inhalation of conidia that are aerosolized from the filamentous form of the organism in the environment. Clinical syndromes typically associated with histoplasmosis include acute or chronic pneumonia, chronic cavitary pulmonary infection, or mediastinal fibrosis or lymphadenitis. Disseminated infection can also occur, in which multiple organ systems are affected. In up to 10% of cases, infection of the central nervous system (CNS) with histoplasmosis may occur with or without disseminated infection. In this review, we discuss challenges related to the diagnosis of CNS histoplasmosis and appropriate treatment strategies that can lead to successful outcomes.
Insights
Histoplasmosis, a fungal infection, can affect anyone and its range is expanding. This review covers challenges in diagnosing and treating central nervous system (CNS) histoplasmosis.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Histoplasmosis is an endemic fungal infection caused by *Histoplasma capsulatum*.
- Its geographic range is expanding, increasing the population at risk.
- Infection occurs via inhalation of fungal conidia.
Purpose of the Study:
- To review diagnostic challenges of central nervous system (CNS) histoplasmosis.
- To discuss appropriate treatment strategies for CNS histoplasmosis.
- To highlight successful outcomes in managing this infection.
Main Methods:
- Literature review of histoplasmosis, focusing on CNS involvement.
- Analysis of diagnostic modalities for CNS histoplasmosis.
- Evaluation of treatment protocols and outcomes for CNS histoplasmosis.
Main Results:
- Histoplasmosis can manifest as pneumonia, chronic pulmonary disease, mediastinal issues, or disseminated disease.
- Central nervous system (CNS) involvement occurs in up to 10% of cases, with or without disseminated infection.
- Diagnosis of CNS histoplasmosis presents significant challenges.
Conclusions:
- Early and accurate diagnosis is crucial for effective management of CNS histoplasmosis.
- Appropriate treatment strategies are essential for successful outcomes.
- Increased awareness of CNS histoplasmosis is needed due to its expanding range and potential severity.
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