An Unusual Presentation of CNS Histoplasmosis Mimicking Metastatic Cancer

Abstract

Histoplasma Capsulatum is a thermally dimorphic fungus that is known to cause histoplasmosis. Inhalation of Histoplasma microconidia into alveolar spaces transforms them into yeasts. Most histoplasma infections are mild or asymptomatic in immunocompetent individuals. However, affected individuals often present with manifestations of an inflammatory response to this infection. Patients often present with bone marrow suppression (pancytopenia) and elevated liver enzymes [1]. Clinical evaluation reveals a flu-like illness with findings of fever, headache, myalgia, dyspnea, chest pain and infection localized to the lungs [2]. Additional manifestations can include involvement of adrenal glands, central nervous system, and skin [3]. Herein, we present a case of disseminated histoplasmosis complicated by CNS and adrenal gland involvement.