{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:16:31Z","timestamp":1789172191239,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Central nervous system (CNS) histoplasmosis occurs in 5%\u201310% of patients with disseminated histoplasmosis, is sparsely described in the literature and is highly morbid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate clinical characteristics and outcomes of patients with CNS and non\u2010CNS disseminated histoplasmosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective case\u2013control study, we matched 45 cases of CNS histoplasmosis with 45 controls with disseminated histoplasmosis without CNS involvement by hospital and date of encounter. Data were collected from three hospitals from January 2000 to December 2022 using histoplasmosis\u2010related ICD\u20109\/10 codes. Patients were classified as confirmed (\n                      <jats:italic>Histoplasma<\/jats:italic>\n                      growth on cerebrospinal fluid [CSF] or CNS culture), probable (positive CSF\n                      <jats:italic>Histoplasma<\/jats:italic>\n                      antigen or antibody), or possible (positive urine or serum\n                      <jats:italic>Histoplasma<\/jats:italic>\n                      antigen plus either CSF WBC \u2265\u20095 cells\/\u03bcL or abnormalities on CNS imaging, with no other evident cause) CNS histoplasmosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CNS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945) and non\u2010CNS disseminated histoplasmosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945) patients had similar demographic and clinical characteristics, although persons living with HIV (PLWH) were more prevalent in the CNS histoplasmosis group (93.3% and 80.0%, respectively,\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      \u20090.019). CSF profiles (CSF WBC, glucose and total protein) and MRI brain imaging were normal in 28.2% and 21.9% of CNS histoplasmosis patients, respectively. CNS histoplasmosis patients were severely ill, with 34.1% requiring ICU care and Glasgow Outcome Scores of 1\u20134 in 51.1% of patients at discharge. In\u2010hospital mortality was 6.7% for CNS vs. 13.3% for disseminated histoplasmosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.215).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large CNS histoplasmosis cohort, we found an increased prevalence of PLWH in CNS vs. non\u2010CNS disseminated histoplasmosis. Similar to prior CNS histoplasmosis cohorts, we report relatively high rates of normal CSF profiles (28.2%) and MRI brain imaging (21.9%). We also found significant morbidity in patients with CNS histoplasmosis, data which were not reported in prior cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70068","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T01:33:39Z","timestamp":1747272819000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Central Nervous System Histoplasmosis: A Retrospective Review of Clinical Characteristics, Treatments and Outcomes With Comparison to Disseminated Histoplasmosis Without Central Nervous System Involvement"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4332-1473","authenticated-orcid":false,"given":"Tyler J.","family":"Brehm","sequence":"first","affiliation":[{"name":"Margaret M. and Albert B. Alkek Department of Medicine, Section of Infectious Disease Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen A.","family":"Staggers","sequence":"additional","affiliation":[{"name":"Institute for Clinical &amp; Translational Research, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Hamill","sequence":"additional","affiliation":[{"name":"Margaret M. and Albert B. Alkek Department of Medicine, Section of Infectious Disease Baylor College of Medicine  Houston Texas USA"},{"name":"Medical Care Line, Infectious Disease Section Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Department of Molecular Virology and Microbiology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Hasbun","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine The University of Texas Health Science Center at Houston  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana M.","family":"El Sahly","sequence":"additional","affiliation":[{"name":"Margaret M. and Albert B. Alkek Department of Medicine, Section of Infectious Disease Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Molecular Virology and Microbiology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2203.151117"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/500405"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2403.171258"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792\u2010199007000\u201000006"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010245"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix706"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13600"},{"key":"e_1_2_9_9_1","volume-title":"The Hispanic Population, 2000","author":"Guzm\u00e1n B.","year":"2001"},{"key":"e_1_2_9_10_1","first-page":"61","article-title":"Cryptococcal Infections in Non\u2010HIV\u2010Infected Patients","volume":"124","author":"Pappas P. G.","year":"2013","journal-title":"Transactions of the American Clinical and Climatological Association"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/313992"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.6.1644"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2008.05.006"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/427880"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.12.026"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13110"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040845"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1086\/521259"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad313"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2111904"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.70068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:58:26Z","timestamp":1789171106000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.70068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/myc.70068"],"URL":"https:\/\/doi.org\/10.1111\/myc.70068","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2024-12-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70068"}}