Central nervous system histoplasmosis mimicking a brain tumor: Difficulties in diagnosis and treatment
Central nervous system histoplasmosis mimicking a brain tumor: Difficulties in diagnosis and treatment
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DOI：
10.4065/74.8.803
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发表时间：
1999-08-01
影响因子：
8.9
通讯作者：
Meyer, FB
中科院分区：
文献类型：
--
作者：
Klein, CJ;Dinapoli, RP;Meyer, FB
10% 至 20% 的播散性组织胞浆菌病患者会出现神经系统受累。我们描述了一名 20 岁女性，她有头痛和复视，但没有全身感染的证据。磁共振成像显示丘脑中脑和第三脑室区域有增强的肿块。在对疑似神经胶质瘤进行次全切除后，患者出现了脑膜炎的症状和体征。随后的病理学检查显示非干酪样肉芽肿，血清学检测和培养证实了组织胞浆菌病的诊断。开始抗真菌治疗和去除受感染的分流系统导致临床改善。临床医生应对来自任何组织胞浆菌病流行地区的患者保持高度怀疑。
Neurologic involvement occurs in 10% to 20% of patients with disseminated histoplasmosis. We describe a 20-year-old woman who had headache and diplopia but no evidence of systemic infection. Magnetic resonance imaging showed an enhancing mass in the thalamomesencephalic and third ventricular region. After subtotal resection of what was presumed to be a glioma, the patient had symptoms and signs of meningitis. Subsequent pathological review demonstrated noncaseating granulomas, and serologic tests and cultures confirmed the diagnosis of histoplasmosis. Initiation of antifungal therapy and removal of an infected shunt system resulted in clinical improvement. Clinicians should maintain a high index of suspicion in patients who are from any area endemic for histoplasmosis.