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. [jhu.pure.elsevier.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]
Entire Body System
- 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. [jhu.pure.elsevier.com]
In infants, symptoms of meningitis are often much less specific and may include irritability or tiredness, poor feeding, and fever. [medicinenet.com]
- Asymptomatic
Coccidiodes immitus type of fungus Specific properties of Coccidiodes immitus Mold in soil • Spherule in tissue • 50% of infections are asymptomatic Diseases caused by Coccidiodes immitus Cocciodiomycosis Meningitis • Osteomyelitis Describe Cocciodiomycosis [quizlet.com]
Infection is usually asymptomatic or minimally symptomatic; however, infection with a large number of organisms or in people with immunodeficiency can result in severe, symptomatic pulmonary infection, which requires treatment. [online.epocrates.com]
Our patient was neurological asymptomatic and the meningitis was like an AML typical meningitis. Histoplasmosis as cause of chronic meningitis in patients with no other evidence of dissemination, is sub-estimated, maybe. [scielo.br]
Approximately 90% of patients with acute pulmonary histoplasmosis are asymptomatic. [emedicine.medscape.com]
The usual disease is self-limited, affects the lungs, and is asymptomatic. Chronic cavitary pulmonary disease, disseminated disease, and meningitis may occur and can be fatal, especially in young children and immunosuppressed patients. [mayocliniclabs.com]
- 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]
Symptoms: Fever Fatigue Shortness of breath Cough Weight loss Diagnosis: Finding the organism in a sample of blood, sputum (spit), or other tissue Treatment: Initial treatment with intravenous amphotericin B, then switch to long-term therapy with oral [thewellproject.org]
- 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]
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]
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]
They begin slowly and not very dramatically: fever and chills, headache and a stiff neck from the inflammation. People lose their appetite, feel ill, can be nauseated and can vomit. [scientificamerican.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]
Disseminated histoplasmosis usually presents clinically with fever, malaise, hepatosplenomegaly, and lymphadenopathy [10]. [ncbi.nlm.nih.gov]
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]
Respiratoric
- Sputum
Histoplasma capsulatum was cultured from CSF but not from sputum, urine, blood or bone marrow. [ncbi.nlm.nih.gov]
The diagnosis is based on the isolation in culture of Histoplasma capsulatum from the cerebrospinal fluid (CSF) of 4 patients, from the sputum of the fifth, and on the presence in all patients of a lymphocytic meningitis with elevated CSF pressure, cell [annals.org]
- Pertussis
Among some of the respiratory infections covered are: Cystic fibrosis infections; Pertussis; Pharyngitis; Fungal infections. [books.google.de]
Encephalitis symptoms may be present with pertussis, tularemia, typhoid, and other acute infections. Brucellosis may appear as chronic meningitis. Neurosyphilis, uncommonly seen in this country today, is nevertheless important. [dartmouth.edu]
Gastrointestinal
- 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]
Skin
- Skin Ulcer
Physical examination will often show hepatosplenomegaly, lymphadenopathy, pallor and petechiae if pancytopenia is present, and, in some patients, mucous membrane ulcerations as well as skin ulcers, nodules, or molluscum-like papules ( 50, 104, 119 ). [cmr.asm.org]
Neurologic
- Meningism
Histoplasma meningitis usually occurs in conjunction with disseminated histoplasmosis. We studied a patient with common variable hypogammaglobulinemia who manifested meningitis without disseminated histoplasmosis. [ncbi.nlm.nih.gov]
Meningitis Publications for Histoplasmosis Meningitis Variations for Histoplasmosis Meningitis Expression for Histoplasmosis Meningitis Search GEO for disease gene expression data for Histoplasmosis Meningitis. [malacards.org]
The CSF abnormalities are similar to those found in cysticercosis, tuberculosis and other fungal meningitis. [n.neurology.org]
SNYDERWHITE CHRS: Successful treatment of histoplasma meningitis with amphotericin B. A case report. J. Pediat. 58: 554, 1961. CrossrefGoogle Scholar 2. NELSONBATESPITCHFORD JDRA: Histoplasma meningitis. Recovery following amphotericin B therapy. [acpjournals.org]
- 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. [jhu.pure.elsevier.com]
Headache, stiff neck, fever, nausea and vomiting, photophobia, and altered mental status are potential symptoms of fungal meningitis. Blood and cerebrospinal fluid are cultured and examined to diagnose fungal meningitis. [medicinenet.com]
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]
- 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 [mayocliniclabs.com]
Symptoms are usually similar to those of acute bacterial meningitis (headache, fever, and stiff neck) but may also include confusion, hearing loss, and double vision. [msdmanuals.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
Headache, stiff neck, fever, nausea and vomiting, photophobia, and altered mental status are potential symptoms of fungal meningitis. Blood and cerebrospinal fluid are cultured and examined to diagnose fungal meningitis. [medicinenet.com]
mental status. 32 Most patients with aspergillus meningitis present with altered mental status, seizures, or focal neurologic deficits. [ahcmedia.com]
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]
Top of Page Signs and Symptoms Signs and symptoms of fungal meningitis include the following: Fever Headache Stiff neck Nausea and vomiting Photophobia (eyes being more sensitive to light) Altered mental status (confusion) Diagnosis If a doctor suspects [cdc.gov]
- Seizure
Seizures: occur more commonly during the acute stage of the disease. [patient.info]
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]
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]
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. [jhu.pure.elsevier.com]
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]
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]
Serum
- 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]
Microbiology
- Toxoplasma Gondii
gondii Neurocysticercosis Trichinosis Naeglaria Hartmannella Bartonella henselae Rocky Mountain spotted fever Typhus Other DBs ICD-10: G03 MeSH: D008582 Reference PMID: 15684450 (description, env_factor, pathogen) Authors Kumar R Title Aseptic meningitis [genome.jp]
Possible causes include fungi, Mycobacterium tuberculosis, rickettsiae, spirochetes, Toxoplasma gondii, HIV, enteroviruses, and disorders such as autoimmune rheumatic disorders (eg, SLE, RA) and cancer. [merckmanuals.com]
Examples include: Taenia solium (cysticercosis), Trichinella spiralis, Toxoplasma gondii, Borrelia burgdorferi (Lyme disease) Fungi are uncommon causes of meningitis. [texaschildrens.org]
Toxoplasma gondii, a parasite associated with cats, can cause parasitic encephalitis in some people with weakened immune systems. Meningitis and encephalitis may start with flu-like symptoms and intensify over a few hours to a few days. [labtestsonline.org]
Candida glabrata, Cryptococcus neoformans, Blastomyces dermatitidis, Penicillium marneffei, Pneumocystis carinii, Toxoplasma gondii, Leishmania and staining artifacts may be misidentified as H. capsulatum. [antimicrobe.org]
- Francisella Tularensis
Causes of Chronic Meningitis (Open Table in a new window) Category Agent Bacteria Mycobacterium tuberculosis Borrelia burgdorferi Treponema pallidum Brucella spp Francisella tularensis Nocardia spp Actinomyces spp Fungi Cryptococcus neoformans Coccidioides [emedicine.medscape.com]
Treatment
[…] granulamatous diseases What is the epidemiology of Coccidiodes immitus Endemic to arid regions of North America • African-American, Filipino at greatest risk for disseminated disease • Women in third trimester of pregnancy at elevated risk What is the treatment [quizlet.com]
[…] 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]
The optimal treatment for CNS histoplamosis, the period of treatment and the recommendation of suppressive therapy is unknown [6,12]. [scielo.br]
Term Treatment of candida meningitis Definition Amphotericin B + Flucytosine or Fluconazole or AmB + fluconazole Term Treatment of Histoplasma, Sporothrix, and blastomyces meningitis Definition Success in ~50% cases Induction: Ambisome Clearance: Itraconazole [flashcardmachine.com]
Treatment of fungal meningitis is with IV antifungal drugs; the length of treatments vary with the patient's immune status. [medicinenet.com]
Prognosis
RUBINFURCOLOWYATESBRASHER HMLJLCA: The course and prognosis of histoplasmosis. Amer. J. Med. 27: 278, 1959. CrossrefMedlineGoogle Scholar 5. MICHAELVOGEL MRA: Histoplasmosis. Report of a case, with observations on management. New Eng. J. [acpjournals.org]
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]
Provides all the information essential for completing a sign-out report: clinical findings, pathologic findings, diagnosis, treatment, and prognosis. [books.google.es]
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]
Etiology
[…] and multiple body system manifestations due to the underlying etiology. [icd10data.com]
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]
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]
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]
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 [mayocliniclabs.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
[…] 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]
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]
Medline (26) Centers for Disease Control and Prevention. [aidscience.org]