急性脊髓病作为弥散性组织胞浆菌病的初始表现:1例报告。

IF 1 Q4 INFECTIOUS DISEASES
Case Reports in Infectious Diseases Pub Date : 2025-04-03 eCollection Date: 2025-01-01 DOI:10.1155/crdi/1124517
Lisle Blackbourn, Elisa Yoo, Michael D Lunt, Umair Hamid
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引用次数: 0

摘要

组织胞浆菌病是一种由真菌荚膜组织胞浆菌引起的真菌感染,很少出现中枢神经系统(CNS)表现,包括脑膜炎、脑炎、局灶性脑或脊髓病变以及中风综合征。由于患者之间的差异,中枢神经系统组织浆菌病是一种难以进行临床诊断的疾病,而没有高灵敏度的诊断测试则进一步阻碍了诊断。在这里,我们提出一个独特的案例,46岁的男性免疫功能低下,由于1型糖尿病和弥散性组织胞浆菌病作为脊髓病的急性表现。患者在就诊前几天左腿无力,神经学检查显示有急性胸椎脊髓病的迹象,特别是与布朗-萨默综合征有关。核磁共振成像显示胸脊髓强化病灶,同时伴有多发脑强化病灶,双侧肾上腺肿块和无数肺结节。活检结果显示酵母形式与组织浆菌种类一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute Myelopathy as Initial Presentation of Disseminated Histoplasmosis: A Case Report.

Histoplasmosis is a fungal infection caused by the fungus Histoplasma capsulatum that can rarely present with central nervous system (CNS) manifestations that include meningitis, encephalitis, focal brain or spinal cord lesions, and stroke syndromes. Because of this variation from patient to patient, CNS histoplasmosis is a difficult clinical diagnosis to make, which can be further hindered by no highly sensitive diagnostic testing available. Here, we present a unique case of a 46-year-old male immunocompromised due to type 1 diabetes mellitus with disseminated histoplasmosis as an acute presentation of myelopathy. Patient had left leg weakness for a few days prior to presentation and a neurological exam remarkable for signs of acute thoracic myelopathy, specifically concerning for Brown-Séquard syndrome. MRI imaging demonstrated an enhancing thoracic spinal cord lesion along with multiple cerebral enhancing lesions, bilateral adrenal masses, and innumerable pulmonary nodules. Biopsy results demonstrated yeast forms consistent with Histoplasma species.

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