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A Case of Histoplasma duboisii Brain Abscess and Review of the Literature
Landry Konan1, Landry Drogba2, Doukoure Brahima3
1Anatomy and Neurosurgery, University Felix Houphouet Boigny, Abidjan, CIV.
Abstract:
Histoplasmosis is a fungal disease caused by Histoplasma capsulatum var. capsulatum (Hcc) and H. capsulatum var. duboisii (Hcd). Central nervous system (CNS) involvement is rare. So far, the few cases reported having Histoplasmosis associated brain abscesses were caused by H. capsulatum var. capsulatum. Herein, we report a unique case of brain abscess caused by H. capsulatum var. duboisii occurring in a 42-year-old immunocompromised woman with HIV. Initially, she presented with hypothermia, vomiting, frontal headache, evolving over one month. She then progressed to have a generalized seizure. Brain MRI showed multifocal brain abscesses and a frontal osteitis. The frontal osteitis was biopsied and confirmed the diagnosis of H. capsulatum var. duboisii. She was successfully treated with liposomal amphotericin B (150 mg daily) for the first four weeks and itraconazole (200mg twice daily) for six months.
Insights
A rare brain abscess caused by Histoplasma capsulatum var. duboisii occurred in an immunocompromised woman with HIV. This case highlights a unique presentation and successful treatment of CNS histoplasmosis.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Histoplasmosis is a fungal infection caused by Histoplasma capsulatum.
- Central nervous system (CNS) involvement in histoplasmosis is uncommon.
- Brain abscesses due to Histoplasma are rare, typically caused by H. capsulatum var. capsulatum.
Observation:
- A 42-year-old immunocompromised woman with HIV presented with hypothermia, vomiting, headache, and seizures.
- Brain MRI revealed multifocal brain abscesses and frontal osteitis.
- Biopsy of the frontal osteitis confirmed Histoplasma capsulatum var. duboisii.
Findings:
- This is the first reported case of a brain abscess caused by Histoplasma capsulatum var. duboisii.
- The patient was successfully treated with liposomal amphotericin B and itraconazole.
Implications:
- This case expands the known spectrum of CNS histoplasmosis.
- It underscores the importance of considering rare fungal pathogens in immunocompromised patients with CNS lesions.
- Effective treatment regimens for CNS histoplasmosis caused by H. capsulatum var. duboisii have been demonstrated.
