title: Cognitive impairment and memory loss associated with histoplasmosis: a case study.
abstract: Histoplasmosis is a rare disease caused by inhalation of the fungus Histoplasma capsulatum. It can spread via cerebral circulation to the central nervous system as a manifestation of a disseminated infection; particularly in patients with immune suppression, which can result in isolated ring-enhancing lesions and inflammation in the brain. Of the reported disseminated histoplasmosis cases (approximately 1 in 2000 per year), only 5-20% have evidence of central nervous system involvement. This paper reviews a single case study of a 57-year-old female diagnosed with disseminated CNS histoplasmosis. Patient's complaints included reduced short-term memory, word-finding problems, and difficulty organizing, making decisions, getting lost while driving, recalling names, retaining information while reading, and slowed processing speed. There was also a history of mild depression and anxiety. Direct testing revealed deficits in multiple cognitive domains including complex attention, processing speed, semantic fluency, visual scanning, motor speed, set-shifting, naming, nonverbal memory, and verbal memory. Neuropsychological deficits suggest cortical and subcortical brain dysfunction, including anterior, temporal, and mesial-temporal regions. This case illustrates the need for neuropsychologists to understand histoplasmosis, the related pathophysiology, and the neuropsychological impact; particularly with the potential for delayed progression.
authors.affiliation: a Walton Rehabilitation Hospital , Augusta , GA , USA.
authors.forename: Ashlee R
authors.initials: AR
authors.lastname: Loughan
authors.forename: Robert
authors.initials: R
authors.lastname: Perna
authors.forename: Jeremy
authors.initials: J
authors.lastname: Hertza
mesh_terms: D001007:Anxiety / Q000209:etiology; D001288:Attention; D001921:Brain / Q000382:microbiology / Q000503:physiopathology; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000523:psychology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000382:microbiology*; D003863:Depression / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006660:Histoplasmosis / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D008569:Memory Disorders / Q000382:microbiology*; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D011932:Reading
keywords: Cognitive; Histoplasmosis; Neuropsychology.