title: Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report.
abstract: OBJECTIVE
  To report a unique presentation of disseminated histoplasmosis.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital, tertiary referral center.
  
  
  METHODS
  Our patient presented with vertigo, tinnitus, and unilateral hearing loss, and was initially found to have a 5-mm enhancing left internal auditory canal mass, as revealed by a magnetic resonance imaging (MRI) scan. Subsequently, the patient developed multiple focal neurologic deficits.
  
  
  METHODS
  Magnetic resonance imaging and treatment with intravenously administered amphotericin B, with subsequent oral administration of itraconazole.
  
  
  METHODS
  Clinical presentation and imaging findings of Histoplasmosis involving the cranial nerve VIII.
  
  
  RESULTS
  A subsequent MRI scan revealed enlargement of the initial lesion and multiple parenchymal lesions. Further workup revealed a pulmonary lesion; the diagnosis of disseminated histoplasmosis was made on the basis of bronchoalveolar lavage culture.
  
  
  CONCLUSIONS
  Infectious processes, including disseminated histoplasmosis, should be considered in the differential of internal auditory canal masses, especially in the setting of rapid progression of symptoms.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Gurgel
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Roehm
authors.forename: Marlan R
authors.initials: MR
authors.lastname: Hansen
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D003937:Diagnosis, Differential; D004432:Ear, Middle; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D000160:Vestibulocochlear Nerve Diseases / Q000175:diagnosis* / Q000473:pathology