[Histoplasmosis of the central nervous system. Report of 2 cases and review of the literature].

Abstract

The involvement of the central nervous system by histoplasma is an infrequent complication. The clinical diagnosis is difficult because the microscopic examination and the culture of the spinal fluid are frequently negative. In this article we report two cases of meningitis by Histoplasma capsulatum in patients with acquired immunodeficiency syndrome. The first case is a meningitis without evidence of disseminated histoplasmosis in a patient who had been treated with amphotericin B. The histologic appearance was that of a granulomatous inflammation of the meninges and the underlying nervous tissue. The second case is a disseminated histoplasmosis with involvement of the central nervous system. This consists of macrophages filled with histoplasma invading the meninges and underlying nervous tissue without associated inflammation.