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Histoplasma Meningitis

Histoplasmosis Meningitis


Presentation

  • A 77-year-old man with chronic obstructive lung disease who was on steroids, presented to the hospital after a fall with subacute headaches and ataxia.[ncbi.nlm.nih.gov]
  • Central nervous system (CNS) involvement is present in 5%–10% of patients with disseminated histoplasmosis [ 1, 2 ]. Clinical presentations include meningitis, hydrocephalus, brain or spinal cord mass lesions, stroke, and encephalitis.[academic.oup.com]
  • Clinical presentations include meningitis, hydrocephalus, brain or spinal cord mass lesions, stroke, and encephalitis. CNS infection may occur with concomitant pulmonary or disseminated disease or may be present in isolation.[ncbi.nlm.nih.gov]
Fever
  • Fever and Skin Rash 292 Fever and the Renal Transplant Recipient 301 Fever Following Travel Abroad 306 Hyperpyrexia and Hyperthermia 316 Fever in the Granulocytopenic Patient 319 Fever of Unknown Origin 325 Recurrent Furunculosis 333 Postoperative Fever[books.google.de]
  • During the patient's hospital course, his clinical condition deteriorated with myoclonic jerks, fevers and severe encephalopathy. An extensive workup, including EEG, brain MRI and lumbar puncture, revealed possible Creutzfeldt-Jakob disease.[ncbi.nlm.nih.gov]
  • Over the ensuing 6-week evaluation, there was occasional fever to 38.5 degrees C. Chest roentgenogram was normal. Cerebral angiography suggested a mass in the left cerebellar hemisphere. EEG was diffusely slow.[ncbi.nlm.nih.gov]
Weight Loss
  • While diarrhea, weight loss, and lethargy are common, Campylobacteriosis can also be present in birds that show no symptoms of illness.[petassure.com]
  • If symptoms are present, they can include fever, tiredness, weight loss, difficult breathing, chest pain, dry cough, headache, anemia, and enlargement of the liver, spleen and lymph nodes. More symptoms are possible the more the disease spreads.[poz.com]
  • If the disease progresses without treatment, those affected may develop weight loss, shortness of breath, and fatigue. Ocular (eye) involvement in disseminated disease can cause loss of vision.[medicinenet.com]
  • People with chronic disseminated histoplasmosis experience mild intermittent fever, weight loss, weakness, anaemia and enlargement of the liver and spleen.[conditions.health.qld.gov.au]
  • If the disease progresses, other symptoms may develop: Fatigue Shortness of breath Pulmonary (lung) nodules Weight loss Vision changes (eye infection with ocular changes to include vision loss) Mouth ulcers Headaches Confusion Seizures Encephalopathy[emedicinehealth.com]
Chills
  • In people, the disease causes flu-like symptoms of fever, chills and headache. If left untreated, Psittacosis can cause liver and kidney damage or even meningitis.[petassure.com]
  • While for most, the only sign of being infected will be small scars on the lungs, but for others, the paroxysmal stage can include: fever, muscle aches, headache, dry cough, chills, chest pain, loss of appetite, and/or sweats.[austincc.edu]
  • The symptoms of pulmonary histoplasmosis are similar to those of pneumonia and include flu-like symptoms such as fever, chills, sweats, a dry cough, malaise, and chest pains. Some affected people also experience joint pains.[medicinenet.com]
  • If a person does become unwell with histoplasmosis, the disease may appear in any of four different forms: Acute respiratory - the illness varies from a mild respiratory illness to feeling generally very unwell with symptoms of tiredness, high fever, chills[conditions.health.qld.gov.au]
  • Symptoms can appear with in 1 week and include fever, chills, headache, non productive cough, myalgia, chest pain, loss of appetite and fatigue. Infection is usually asymptomatic for low level exposure or mild infections.[msdsonline.com]
Malaise
  • Clinical manifestations include headache, fever, malaise, photophobia, and meningeal signs.[genome.jp]
  • […] include fever, headache, nonproductive cough, chills, pleuritic chest pain, weight loss, malaise, myalgias, and sweats.[aafp.org]
  • The symptoms of pulmonary histoplasmosis are similar to those of pneumonia and include flu-like symptoms such as fever, chills, sweats, a dry cough, malaise, and chest pains. Some affected people also experience joint pains.[medicinenet.com]
  • Fever and other systemic findings are characteristic (chills, fever, anorexia, malaise, diarrhea, weight loss, hepatosplenomegaly, anemia, leukopenia, thrombocytopenia). Sepsis syndrome with ARDS can be seen.[clinicaladvisor.com]
  • The symptoms of disseminated histoplasmosis include fever, malaise, anorexia, and weight loss.[cmr.asm.org]
Movement Disorder
Failure to Thrive
  • Fred Ferri’s popular "5 books in 1" format provides quick guidance on menorrhagia, Failure to Thrive (FTT), Cogan’s syndrome, and much more.[books.google.de]
Hematochezia
  • […] involvement as a relapse of disseminated histoplasmosis in an Italian AIDS patient , J Infect , 1997 , vol. 35 (pg. 83 - 4 ) 25 Case record of the Massachusetts General Hospital: case 4–1994—a 38-year-old man with AIDS and the recent onset of diarrhea, hematochezia[academic.oup.com]
Leg Pain
  • He had been well until August, 1964, when he had a thromboembolectomy of the left iliac artery at another hospital after a short history of leg pain and swelling. Subsequently, he . . .[nejm.org]
  • However, more nonspecific features such as leg pain, cold hands and feet and abnormal skin colour appeared much earlier with a median onset of 7-12 hours.[patient.info]
Tinnitus
  • ., a 66-year-old Caucasian male, clerical worker, developed occasional episodes of dizziness and tinnitus in mid-1971. During 1972, increasing frequency of these episodes and gradually progressive confusion were noted.[ncbi.nlm.nih.gov]
Furunculosis
  • Fever and Skin Rash 292 Fever and the Renal Transplant Recipient 301 Fever Following Travel Abroad 306 Hyperpyrexia and Hyperthermia 316 Fever in the Granulocytopenic Patient 319 Fever of Unknown Origin 325 Recurrent Furunculosis 333 Postoperative Fever[books.google.de]
Headache
  • A 77-year-old man with chronic obstructive lung disease who was on steroids, presented to the hospital after a fall with subacute headaches and ataxia.[ncbi.nlm.nih.gov]
  • Duarte, 3 in 1945, reported the case of a 23-year-old woman with headache, photophobia, nausea, and vomiting but no signs of meningeal irritation. At autopsy, the patient had a basilar meningeal exudate and lesions in[jamanetwork.com]
  • From suspected Creutzfeldt-Jakob disease to confirmed histoplasma meningitis Summary A 77-year-old man with chronic obstructive lung disease who was on steroids, presented to the hospital after a fall with subacute headaches and ataxia.[casereports.bmj.com]
Confusion
  • During 1972, increasing frequency of these episodes and gradually progressive confusion were noted. In January 1973, vomiting, forther confusion, obnubilation, and a left central facial paresis developed and he was hospitalized.[ncbi.nlm.nih.gov]
  • Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances Antibody levels may be low in spinal fluid in cases of Histoplasma meningitis[mayomedicallaboratories.com]
  • Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances Histoplasma : -Antibody levels may be low in spinal fluid in cases of Histoplasma[mayomedicallaboratories.com]
  • [ edit ] Symptoms of fungal meningitis are generally similar to those of other types of meningitis, and include: a fever, stiff neck, severe headache, photophobia (sensitivity to light), nausea and vomiting, and altered mental status (drowsiness or confusion[en.wikipedia.org]
Altered Mental Status
  • Signs and symptoms [ edit ] Symptoms of fungal meningitis are generally similar to those of other types of meningitis, and include: a fever, stiff neck, severe headache, photophobia (sensitivity to light), nausea and vomiting, and altered mental status[en.wikipedia.org]
  • mental status. 32 Most patients with aspergillus meningitis present with altered mental status, seizures, or focal neurologic deficits.[ahcmedia.com]
  • Top of Page Signs and Symptoms Signs and symptoms of fungal meningitis may include the following: Fever Headache Stiff neck Nausea and vomiting Photophobia (sensitivity to light) Altered mental status (confusion) Diagnosis If meningitis is suspected,[cdc.gov]
  • A fifth patient, who was receiving antibiotics for Helicobacter pylori gastritis, developed fever, altered mental status, rash, and eosinophilia. CSF leukocyte count was 4 cells/µL, the glucose was 55 mg/dL, and the protein was 28 mg/dL.[ncbi.nlm.nih.gov]
Seizure
  • Symptoms of histoplasmosis range from none to flu -like symptoms ( fever , dry cough , chest discomfort); severe infections may cause vision problems, mouth ulcers, seizures , encephalopathy , and death.[emedicinehealth.com]
  • Seizures: occur more commonly during the acute stage of the disease.[patient.info]
  • The initial seizure activity described was due to fungal meningitis ( C. neoformans is often referred to as neurotropic).[vet.uga.edu]
  • Cortical vein thrombosis produces hemorrhagic infarction of the cortex, with resultant focal signs and (often) seizures.[dartmouth.edu]
Myoclonic Jerking
  • During the patient's hospital course, his clinical condition deteriorated with myoclonic jerks, fevers and severe encephalopathy. An extensive workup, including EEG, brain MRI and lumbar puncture, revealed possible Creutzfeldt-Jakob disease.[ncbi.nlm.nih.gov]
  • Pupillary changes, myoclonic jerks, and tremor are also frequently present.[dartmouth.edu]

Workup

  • An extensive workup, including EEG, brain MRI and lumbar puncture, revealed possible Creutzfeldt-Jakob disease. Unfortunately, the patient failed to improve and died 12 days after admission.[ncbi.nlm.nih.gov]
  • An extensive workup, including EEG, brain MRI and lumbar puncture, revealed possible Creutzfeldt-Jakob disease. Unfortunately, the patient failed to improve and died 12 days after admission.[jhu.pure.elsevier.com]
  • Neurological exam remained normal on subsequent neurology clinic visits, and a sedated lumbar puncture was planned as the next step in his workup.[journals.lww.com]
Hyponatremia
  • Inappropriate antidiuretic hormone (ADH) secretion may result in hyponatremia from water excess and salt loss. Water restriction is usually effective in treating this transient complication.[dartmouth.edu]
  • Hyperkalemia, hyponatremia, and eosinophilia are usually present. CT scan shows markedly enlarged adrenals, often with necrosis in the central area ( 160 ). Adrenal insufficiency was a frequent cause of death in earlier years ( 110 ).[cmr.asm.org]
Helicobacter Pylori
  • A fifth patient, who was receiving antibiotics for Helicobacter pylori gastritis, developed fever, altered mental status, rash, and eosinophilia. CSF leukocyte count was 4 cells/µL, the glucose was 55 mg/dL, and the protein was 28 mg/dL.[ncbi.nlm.nih.gov]
Histoplasma Duboisii
  • duboisii, without mention of manifestation 115.11 Infection by Histoplasma duboisii, meningitis 115.12 Infection by Histoplasma duboisii, retinitis 115.13 Infection by Histoplasma duboisii, pericarditis 115.14 Infection by Histoplasma duboisii, endocarditis[healthprovidersdata.com]
  • -- Citation "115.11 - Infection By Histoplasma Duboisii, Meningitis."[unboundmedicine.com]
  • 2012 ICD-9-CM Diagnosis Code 115.11 Infection by Histoplasma duboisii, meningitis Short description: Histoplasm dubois mening.[icd9data.com]
  • duboisii 115.10 Infection by Histoplasma duboisii, without mention of manifestation convert 115.10 to ICD-10-CM 115.11 Infection by Histoplasma duboisii, meningitis convert 115.11 to ICD-10-CM 115.12 Infection by Histoplasma duboisii, retinitis convert[icd9data.com]

Treatment

  • […] and Prevention of Influenza 480 AIDS 78 Transmission and Prevention of HIV Infection 489 Primary HIV infection 496 Treatment of Pneumocystis Carinii Pneumonia in AIDS 499 HIV1 and Infections of the Central Nervous System 504 Fever in the HIVinfected[books.google.de]
  • Treatment with 2.51 gm of amphotericin B given intravenously over a 3-month period resulted in complete reversal of all neurologic signs and clearing of the confusion. The remission has been maintained for two years.[ncbi.nlm.nih.gov]
  • The antigen assay has evolved to a fourth-generation EIA [ 7 ] that incorporates EDTA treatment [ 11 ]. Using EDTA treatment, the sensitivity of antigen detection in the CSF was 85% in the current study.[ncbi.nlm.nih.gov]

Prognosis

  • The duration of treatment is dependent upon the causal pathogen and the patient's ability to stave off the infection; for patients with a weaker immune system or diabetes, treatment will often take longer. [2] Prognosis [ edit ] Prognosis depends on the[en.wikipedia.org]
  • What is the prognosis of histoplasmosis? People with mild symptoms of histoplasmosis usually resolve the disease on their own without treatment. In more severe cases, the prognosis is good for those who receive appropriate treatment.[medicinenet.com]
  • Prognosis and Patient Counseling. The prognosis of mild to moderate infections in immunocompetent patients is usually good.[clinicaladvisor.com]

Etiology

  • Methods Patients were classified as cases if there was CNS inflammation (CSF WBC 5 mm 3 /ml) plus laboratory confirmation of H. capsulatum in CNS samples or from extra-CNS sites with no alternative etiology for CSF pleocytosis.[aspergillus.org.uk]
  • In 183 short chapters, the book provides the essentials clinicians need on symptoms/signs, diagnostic tests, and neurologic disorders of all etiologies. For this edition, Timothy A.[books.google.de]
  • BACKGROUND: Chronic meningitis encompasses a heterogeneous group of etiologies. Rarely, histoplasmosis may arise as an isolated neurological syndrome in immunocompetent hosts without evidence of general dissemination.[n.neurology.org]

Epidemiology

  • […] of infections are asymptomatic Diseases caused by Coccidiodes immitus Cocciodiomycosis Meningitis • Osteomyelitis Describe Cocciodiomycosis Erythema nodosum - Desert bumps • Non-specific to disease; side effect of granulamatous diseases What is the epidemiology[quizlet.com]
  • The ecology of Cryptococcus neoformans and the epidemiology of cryptococcosis. Rev Infect Dis 1991; 13: 1163-1169. Medline (7) Perfect JR, Granger DL, Durack DT.[aidscience.org]
  • Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general.[jmm.microbiologyresearch.org]
  • Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Med Mycol. 2007; 45(4): 321-46. PubMed Saccente M, Woods GL. Clinical and laboratory update on blastomycosis. Clin Microbiol Rev. 2010; 23(2): 367-81. PubMed Tuon FF, Costa SF.[arupconsult.com]
  • Epidemiologic Risks Histoplasma capsulatum var. capsulatum (Western hemisphere. Missisippi River valley up into Ontario, caves in the Caribbean, Central Mexico, and Mexico. There is also cases in Asia and Africa.[pusware.com]
Sex distribution
Age distribution

Pathophysiology

  • Useful For Suggests clinical disorders or settings where the test may be helpful Aiding in the diagnosis of Histoplasma meningitis in spinal fluid specimens Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they[mayomedicallaboratories.com]
  • Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Histoplasma Histoplasma capsulatum is a soil saprophyte that grows well in soil enriched with bird droppings.[mayomedicallaboratories.com]
  • Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Clin Infect Dis. 1997;24:1195–1203 9. Wheat LJ, Kohler RB, Tewari RP, et al.[journals.lww.com]
  • […] profound, can calcify Extrapulmonary findings: Liver and spleen calcifications, adrenals, oral ulcers, bone marrow Differentials: Sarcoidosis and tuberculosis Usual treatment: Itraconazole; amphotericin for severe or diffuse disease Prognosis: Excellent Pathophysiology[emedicine.medscape.com]

Prevention

  • The lack of humoral and cellular response to histoplasma in CSF may have allowed meningitis to develop, while the cellular response to histoplasma elsewhere prevented development of disseminated histoplasmosis.[ncbi.nlm.nih.gov]
  • […] of Influenza 480 AIDS 78 Transmission and Prevention of HIV Infection 489 Primary HIV infection 496 Treatment of Pneumocystis Carinii Pneumonia in AIDS 499 HIV1 and Infections of the Central Nervous System 504 Fever in the HIVinfected Patient 516 Prevention[books.google.de]
  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.de]

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