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Histoplasmosis Presenting as an Isolated Spinal Cord Lesion
Arch Neurol. 2006;63:1802-1803.
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A 27-year-old previously healthy migrant farm worker presented with progressive bilateral lower extremity weakness that had developed during the preceding month. His physical examination results were notable for bilateral lower extremity weakness (right greater than left), clonus in the right foot, diminished sensation to pinprick from T9 through S1 bilaterally, and incontinence of bowel and bladder. He was also noted to have superficial white onychomycosis on multiple digits (Figure 1).
Figure appears in full text version.
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Figure 1. Superficial white onychomycosis in our patient. The condition is often associated with immunosuppression.
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Magnetic resonance imaging of the spine (Figure 2) showed a 10 x 9 x 14-mm intramedullary lesion centered at C7-8, with extensive T2 hyperintensity and marked expansion of the entire spinal cord. Computed tomographic scans of his chest and head were normal. Analysis of the cerebrospinal fluid showed a white blood cell count of 159 cells/µL (92% lymphocytes, 7% macrophages, and . . . [Full Text of this Article] AUTHOR INFORMATION
Paul L. Bollyky, MD, DPhil;
Todd J. Czartoski, MD;
Ajit Limaye, MD
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