Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of histoplasmosis with chronic basilar meningitis diagnosed relatively early

Asako Onda, M.D.1), Shinji Miyagawa, M.D.1), Taku Gomi, M.D.2), Tetuya Horino, M.D.3), Katuhiko Kamei, M.D.4) and Hiroshi Yaguchi, M.D.1)

1)Department of Neurology, The Jikei University Kashiwa Hospital
2)Department of Radiology, The Jikei University Kashiwa Hospital
3)Department of Infection Control Unit, The Jikei University Kashiwa Hospital
4)Department of Clinical Research, Medical Mycology Research Center, Chiba University

A 41-year-old man left for Mexico in May 2015. Right pulmonary nodule was detected at a health examination in May 2016, and he subsequently showed headache and slight fever. Contrast-enhanced magnetic resonance imaging of the brain revealed basilar meningitis, so he was admitted to our hospital. We considered imported mycosis due to his travel history to Mexico. We diagnosed histoplasmosis based on the presence of antibodies against Histoplasma in both serum and cerebrospinal fluid. Symptoms almost completely recovered with a liposomal formulation of amphotericin B. Central nervous system histoplasmosis is very rare in Japan. Immunocompetent hosts can develop histoplasmosis, and this pathology is important to consider in patients presenting with basilar meningitis and a positive travel history.
Full Text of this Article in PDF (498K)

(CLINICA NEUROL, 58: 241|244, 2018)
key words: imported mycosis, histoplasmosis, basilar meningitis, immunocompetent host, tuberculosis

(Received: 15-Jan-18)