title: Central Nervous System Histoplasmosis in Acquired Immunodeficiency Syndrome.
abstract: BACKGROUND
  Involvement of the central nervous system (CNS) by Histoplasma capsulatum in AIDS is uncommon and not easily recognized.
  
  
  METHODS
  CNS histoplasmosis cases from our institution were identified by a retrospective chart review from 2004-2014. A thorough literature search was performed for additional cases and their characteristics were compared. Clinical findings, treatment and outcomes are discussed.
  
  
  RESULTS
  A total of 5 cases from our institution were identified. They had a clinical presentation that included classic signs of meningitis, often with evidence of disseminated involvement, and was typically severe with important neurological impairment. These cases were treated with antifungal agents, including a lipid amphotericin B formulation and azole drugs, but eventually 3 experienced nonresolution of their disease likely because of lack of adherence to therapy and died from their infection. The clinical presentation, treatment and outcome of these cases did not significantly differ from cases found in the review of the literature.
  
  
  CONCLUSIONS
  Clinicians practicing in endemic areas should be aware of this rare but serious form of histoplasmosis. The recognition of 5 cases of CNS histoplasmosis in AIDS patients from a single institution suggests that histoplasmosis should be included in the differential diagnosis of the CNS complications of AIDS.
authors.affiliation: Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas. Electronic address: harita.nyalakonda@gmail.com.
authors.forename: Harita
authors.initials: H
authors.lastname: Nyalakonda
authors.affiliation: Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Marisol
authors.initials: M
authors.lastname: Albuerne
authors.affiliation: Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Lia Patricia
authors.initials: LP
authors.lastname: Suazo Hernandez
authors.affiliation: Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Sarria
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D001921:Brain / Q000473:pathology; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D005260:Female; D006658:Histoplasma / Q000502:physiology*; D006660:Histoplasmosis / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000382:microbiology; D008875:Middle Aged; D012189:Retrospective Studies; D013781:Texas
keywords: AIDS; Central nervous system; HIV; Histoplasma capsulatum; Histoplasmosis