|
|
Clin Infect Dis 2000 Mar;30(3):595-598 |
| Prostatic and Central Nervous System Histoplasmosis in an
Immunocompetent Host: Case Report and Review of the Prostatic
Histoplasmosis Literature. |
|
Mawhorter SD, Curley GV, Kursh ED, Farver CE |
| Department of Infectious Disease, Cleveland Clinic Foundation,
Cleveland, OH, 44195, USA.
|
| Histoplasmosis is a common cause of systemic mycosis in areas of the
United States where it is endemic. Central nervous system and
genitourinary histoplasmosis is rare, especially in immunocompetent
hosts. We describe a case of disseminated histoplasmosis in a normal
host that was associated with cerebral and prostatic histoplasmosis
presenting as fever of undetermined origin, weight loss, and severe
debilitating altered mental status. |
| The patient subsequently developed
acute renal failure that manifested as obstructive uropathy during
antifungal therapy with amphotericin B. Transurethral resection of the
prostate resulted in improved renal function during continuation of
amphotericin B therapy. |
| Pathological analysis of the prostate revealed
necrotizing granulomas with intralesional fungal organisms. Blood and
urine cultures were positive for Histoplasma capsulatum. Diagnostic
issues and management are discussed. Treatment resulted in return of
normal cognitive and motor function. This case is compared with the 8
previously reported cases of H. capsulatum prostatitis.
|
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