Can histoplasmosis go to the brain?

Histoplasmosis is a fungal infection caused by the inhalation of spores from the fungus Histoplasma capsulatum. While the lungs are the primary site of infection, the fungus can also spread to other parts of the body, including the central nervous system (CNS). In fact, 5 to 10% of individuals with disseminated histoplasmosis develop CNS involvement.

Clinical Features and Diagnosis

CNS histoplasmosis can present in various ways, including chronic meningitis, focal brain or spinal cord lesions, stroke syndromes, encephalitis, and hydrocephalus. It is important to note that CNS histoplasmosis can occur in both immunocompromised and immunocompetent individuals.

Diagnosing CNS histoplasmosis can be challenging, as routine cultures of cerebrospinal fluid (CSF) are often negative. However, antigen and antibody testing of the CSF can help establish the diagnosis. In fact, these tests are more sensitive than culture and can detect the presence of Histoplasma antigen or anti-Histoplasma antibodies in the CSF in 75% of patients.

Treatment and Prognosis

The Infectious Disease Society of America (IDSA) recommends treatment with liposomal amphotericin B (AMB-L) for at least 1 month, followed by itraconazole for at least 1 year. This treatment regimen has been shown to improve survival rates among patients with CNS histoplasmosis.

Mortality rates for CNS histoplasmosis remain high, particularly in immunocompromised patients and those over 54 years of age. Poor adherence to treatment is also associated with higher mortality rates. However, one-year survival rates among patients treated initially with AMB-L range from 56.2% to 81.2%.

Conclusion

CNS histoplasmosis is a rare but serious condition that can occur in both immunocompromised and immunocompetent individuals. Prompt diagnosis and treatment are crucial for improving patient outcomes. If you suspect you may have CNS histoplasmosis or need assistance with the removal and cleaning of bird droppings or nests, please contact Bird Poop Cleaning at hello@khunclean.com or 082-797-3702.

Please note: Bird Poop Cleaning is not responsible for the diagnosis or treatment of CNS histoplasmosis. This post is for informational purposes only and should not be used as a substitute for professional medical advice.