Journal
CLINICAL INFECTIOUS DISEASES
Volume 40, Issue 6, Pages 844-852Publisher
OXFORD UNIV PRESS INC
DOI: 10.1086/427880
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Two cases of Histoplasma meningitis are presented, illustrating the difficulty in diagnosis and treatment. The first case occurred in a patient with acquired immunodeficiency syndrome as a relapse of disseminated histoplasmosis and resolved after prolonged treatment and ongoing antiretroviral therapy. The second case occured in a cardiac allograft recipient as meningitis and focal brain lesions that responded to liposomal amphotericin B, but the patient died shortly after therapy was completed. Unfortunately, there are no prospective studies addressing the diagnosis and management of patients with histoplasmosis of the central nervous system from which to provide evidence- based guidelines for care. In the absence of such data, an approach will be presented on the basis of our experience and opinions.
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