[Histoplasmosis of the central nervous system: study of cerebrospinal fluid in 8 patients].
One hundred and thirteen samples of CSF from eight patients with chronic meningitis were studied in a 12 years period (September, 1980-August, 1992). None of them had AIDS. In all, CNS histoplasmosis diagnosis was made by CSF examination. All cases tested positive for antibodies to Histoplasma capsulatum in CSF; in one case the yeast grew in Sabouraud culture in three different occasions. The main findings in CSF by the time of the diagnosis were: moderate hypercytosis marked by lymphocytes and monocytes, neutrophils-being present and in some cases eosinophil cells; moderate increase of total proteins content; decrease in the glucose content; and moderate increase of gamma globulins sometimes with oligoclonal reaction. Patients were followed-up from 7 to 102 months, and periodically submitted to CSF examinations according to clinics. Cell number and total protein content of CSF showed marked episodes of exacerbation in the follow-up, with a dissociated profile favoring total protein content which got higher with the chronification of the disease. Changes in the CSF pattern with treatment were: rapid decrease of hypercytosis; disappearence of neutrophil and eosinophil cells; increase in glucose content; and slow reduction of the increased contents of total proteins and gamma globulins.
Livramento
J A
JA
CIN, Centro de Investigações em Neurologia, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brasil.
Machado
L R
LR
Nóbrega
J P
JP
Vianna
L S
LS
Spina-França
A
A
D000293:Adolescent; D000328:Adult; D000908:Antibodies, Fungal / Q000302:isolation & purification; D001927:Brain Diseases / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D002648:Child; D003168:Complement Fixation Tests; D003937:Diagnosis, Differential; D005260:Female; D006660:Histoplasmosis / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008875:Middle Aged
D000908:Antibodies, Fungal
Histoplasmose do sistema nervoso central. Estudo do líquido cefalorraqueano em 8 pacientes.