Intracerebral hemorrhage in disseminated histoplasmosis in advanced HIV infection: A case report.
Anthony Ayala-Inga, Alfredo Rebaza-Mateo, Juan Carlos Díaz-Monge et al.
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Case in brief
A 26-year-old woman with untreated HIV presented with weight loss, jaundice, and lymphadenopathy, later developing seizures and meningeal signs. Neuroimaging revealed a left temporo-occipital hematoma and subarachnoid hemorrhage. A lymph node biopsy and positive Histoplasma urinary antigen confirmed disseminated histoplasmosis. After treatment with amphotericin B and antiretroviral therapy, she experienced significant neurological recovery.
What made this case unusual
The case highlights the rare occurrence of intracranial hemorrhage associated with disseminated histoplasmosis in an immunocompromised patient, which can mimic cerebral tuberculosis.
Diagnostic / clinical pearl
Clinicians should consider disseminated histoplasmosis in immunocompromised patients presenting with neurological symptoms, especially in endemic regions.
Why it matters
Recognizing the potential for CNS involvement in disseminated histoplasmosis is crucial for timely diagnosis and treatment, which can significantly improve patient outcomes.