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Related Experiment Videos

Central nervous system histoplasmosis with obstructive hydrocephalus.

D A Enarson, T F Keys, B M Onofrio

    The American Journal of Medicine
    |May 1, 1978
    PubMed
    Summary

    Central nervous system histoplasmosis can obstruct the fourth ventricle. This case highlights treatment challenges with amphotericin B, even with intrathecal administration, due to severe side effects.

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    Area of Science:

    • Neurology
    • Infectious Diseases
    • Mycology

    Background:

    • Central nervous system (CNS) histoplasmosis is a rare but serious fungal infection.
    • Obstruction of the fourth ventricle is a critical complication that can lead to hydrocephalus and increased intracranial pressure.

    Observation:

    • A patient presented with CNS histoplasmosis causing fourth ventricle obstruction.
    • Systemic symptoms were minimal despite positive Histoplasma capsulatum cultures from bone marrow, blood, and urine.
    • Recurrent infection occurred after 5g of systemic amphotericin B.

    Findings:

    • Intrathecal amphotericin B was initiated for recurrent infection.
    • Treatment was halted due to the development of transverse myelitis, a severe neurological complication.
    • This case demonstrates the complex management and potential toxicity of amphotericin B in CNS histoplasmosis.

    Implications:

    • Effective treatment strategies for CNS histoplasmosis require careful consideration of drug efficacy and toxicity.
    • Neurological complications like transverse myelitis necessitate prompt recognition and management.
    • Further research into safer and more effective therapies for disseminated and CNS histoplasmosis is warranted.

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