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Successful Treatment of Histoplasmosis Brain Abscess With Voriconazole
Jayashri Srinivasan, MBBS, PhD, MRCP;
Winnie W. Ooi, MD, MPH, DMD
Arch Neurol. 2008;65(5):666-667.
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A 35-year-old heterosexual man had reduced dexterity in his right hand and difficulty writing; examination revealed right hand incoordination and reduced dexterity. Eight years ago he had had disseminated histoplasmosis, without central nervous system (CNS) involvement, that was successfully treated with 8 months of itraconazole. Brain magnetic resonance imaging revealed right cerebellar and frontal lobe rim-enhancing lesions with central lucency (Figure 1A). The cerebellar lesion was surgically resected. Pathologic examination revealed granulomas and yeast forms (Figures 2A and 2B) and a fungal culture was positive for Histoplasma capsulatum. The patient was also found to have liver and bone marrow involvement consistent with disseminated histoplasmosis. His Histoplasma urine antigen level was 6.15 U (normal, < 1.0 U). He had mild neutropenia; the absolute granulocyte count was 1.53 K/µL (reference range, 1.6-9.8 K/µL). He had a . . . [Full Text of this Article]AUTHOR INFORMATION
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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