{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T18:05:46Z","timestamp":1775844346140,"version":"3.50.1"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The diagnosis of central nervous system histoplasmosis is challenging because histoplasmosis can mimic tuberculosis and the performance of mycological diagnostic methods in the cerebrospinal fluid is questionable. A 50-year-old woman with HIV infection, living in Amapa (northern Brazil), on suboptimal antiretroviral therapy for 8 years, presented to our unit with a 3-year history of recurrent undocumented meningoencephalitis, with several unsuccessful empirical antituberculosis and partially successful anticryptococcal regimens, and presented progressive motor weakness in the lower limbs, difficulty walking, and urinary and fecal incontinence for 6 months. Repeated lumbar punctures for mycological culture and\n                    <jats:italic>Histoplasma<\/jats:italic>\n                    polymerase chain reaction test were necessary to confirm the diagnosis. After 6 weeks of liposomal amphotericin B followed by itraconazole and intensification of her antiretroviral therapy, she improved clinically and biologically.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.24-0586","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T16:20:49Z","timestamp":1765470049000},"page":"360-363","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Undocumented Meningoencephalitis due to Histoplasmosis in an HIV-Infected Patient in Brazil"],"prefix":"10.4269","volume":"114","author":[{"given":"Kim","family":"Henry","sequence":"first","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ugo","family":"Fran\u00e7oise","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"},{"name":"Centre d\u2019Investigation Clinique Antilles-Guyane CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"},{"name":"Coordination R\u00e9gionale de Lutte Contre le Virus de L\u2019immunod\u00e9ficience Humaine, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9line","family":"Durand","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Salloum","sequence":"additional","affiliation":[{"name":"Service de Neurochirurgie, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9gonde","family":"About","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"},{"name":"Centre d\u2019Investigation Clinique Antilles-Guyane CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Lesens","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Weber","sequence":"additional","affiliation":[{"name":"Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"Djossou","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magaly","family":"Zappa","sequence":"additional","affiliation":[{"name":"Service de Radiologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lo\u00efc","family":"Epelboin","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"},{"name":"Centre d\u2019Investigation Clinique Antilles-Guyane CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Le Turnier","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"},{"name":"Centre d\u2019Investigation Clinique Antilles-Guyane CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Infect Dis","first-page":"1150","article-title":"Burden of HIV-associated histoplasmosis compared with tuberculosis in Latin America: A modelling study","volume":"18","author":"Adenis","year":"2018"},{"key":"b2","series-title":"Medicine (Baltimore)","first-page":"244","article-title":"Histoplasma capsulatum infections of the central nervous system. A clinical review","volume":"69","author":"Wheat","year":"1990"},{"key":"b3","series-title":"Am J Trop Med Hyg","first-page":"216","article-title":"Tuberculosis and histoplasmosis among human immunodeficiency virus-infected patients: A comparative study","volume":"90","author":"Adenis","year":"2014"},{"key":"b4","series-title":"BMJ Case Rep","first-page":"e235531","article-title":"Disseminated histoplasmosis and tuberculosis: Dual infection in a non-endemic region","volume":"13","author":"Anot","year":"2020"},{"key":"b5","series-title":"Am J Trop Med Hyg","first-page":"125","article-title":"Histoplasmosis of the central nervous system: A case series between 1990 and 2019 in French Guiana","volume":"105","author":"Epelboin","year":"2021"},{"key":"b6","series-title":"J Fungi (Basel)","first-page":"70","article-title":"Central nervous system infection with Histoplasma capsulatum.","volume":"5","author":"Riddell","year":"2019"},{"key":"b7","series-title":"Medicine (Baltimore)","first-page":"e0245","article-title":"Central nervous system histoplasmosis: Multicenter retrospective study on clinical features, diagnostic approach and outcome of treatment","volume":"97","author":"Wheat","year":"2018"},{"key":"b8","series-title":"Surg Neurol Int","first-page":"83","article-title":"Intramedullary histoplasmosis lesion in children: A case report","volume":"13","author":"Cavalcante Filho","year":"2022"},{"key":"b9","series-title":"J Spinal Disord Tech","first-page":"212","article-title":"Intramedullary histoplasmosis spinal cord abscess in a nonendemic region: Case report and review of the literature","volume":"16","author":"Hott","year":"2003"},{"key":"b10","series-title":"Neurosurgery","first-page":"E1146; discussion E1146","article-title":"Spinal intramedullary histoplasmosis as the initial presentation of human immunodeficiency virus infection: Case report","volume":"59","author":"Manning","year":"2006"},{"key":"b11","series-title":"J Neurol Surg Rep","first-page":"e167","article-title":"Histoplasmosis with deep CNS involvement: Case presentation with discussion and literature review","volume":"76","author":"Hariri","year":"2015"},{"key":"b12","series-title":"Rev Med Interne","first-page":"389","article-title":"[Disseminated and central nervous system Histoplasma capsulatum infection mimicking neoplasm: Difficulties in diagnosis, failure in management]","volume":"24","author":"Nicolas","year":"2003"},{"key":"b13","series-title":"Scand J Infect Dis","first-page":"43","article-title":"Isolated central nervous system histoplasmosis in immunocompetent hosts: A series of 11 cases","volume":"38","author":"Schestatsky","year":"2006"},{"key":"b14","series-title":"Diagn Microbiol Infect Dis","first-page":"115952","article-title":"The incidence of histoplasmosis and cryptococcal antigenemia among patients attending a large HIV clinic in Trinidad","volume":"106","author":"Edwards","year":"2023"},{"key":"b15","series-title":"BMC Infect Dis","first-page":"406","article-title":"Implementation of a rapid diagnostic assay package for cryptococcosis, histoplasmosis and tuberculosis in people living with HIV in Paraguay","volume":"24","author":"Aguilar","year":"2024"},{"key":"b16","series-title":"Clin Neurol Neurosurg","first-page":"176","article-title":"Histoplasmoma: Isolated central nervous system infection with Histoplasma capsulatum in a patient with AIDS. Case report and brief review of the literature","volume":"109","author":"Azizirad","year":"2007"},{"key":"b17","series-title":"Med J Aust","first-page":"201","article-title":"Cerebral histoplasmosis in an Australian patient with systemic lupus erythematosus","volume":"169","author":"Sullivan","year":"1998"},{"key":"b18","series-title":"Arch Intern Med","first-page":"217","article-title":"Meningoencephalitis caused by Histoplasma capsulatum: Occurrence in a renal transplant recipient and a review of the literature","volume":"136","author":"Karalakulasingam","year":"1976"},{"key":"b19","series-title":"Neurol Neurocir Psiquiatr","first-page":"403","article-title":"Histoplasma meningitis with common variable hypogammaglobulinemia","volume":"18","author":"Couch","year":"1977"},{"key":"b20","series-title":"Mycopathologia","first-page":"331","article-title":"Primary central nervous system infection by Histoplasma in an immunocompetent adult","volume":"185","author":"de Almeida","year":"2020"},{"key":"b21","series-title":"J Child Neurol","first-page":"532","article-title":"Isolated Histoplasma capsulatum meningoencephalitis in an immunocompetent child","volume":"27","author":"Threlkeld","year":"2012"},{"key":"b22","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"658","article-title":"A case of HIV-associated cerebral histoplasmosis successfully treated with fluconazole","volume":"18","author":"Knapp","year":"1999"},{"key":"b23","series-title":"Pediatr Neurol","first-page":"151","article-title":"Chronic progressive CNS histoplasmosis presenting in childhood: Response to fluconazole therapy","volume":"8","author":"Rivera","year":"1992"},{"key":"b1","series-title":"Lancet Infect Dis","first-page":"1150","article-title":"Burden of HIV-associated histoplasmosis compared with tuberculosis in Latin America: A modelling study","volume":"18","author":"Adenis","year":"2018"},{"key":"b2","series-title":"Medicine (Baltimore)","first-page":"244","article-title":"Histoplasma capsulatum infections of the central nervous system. 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Case report and brief review of the literature","volume":"109","author":"Azizirad","year":"2007"},{"key":"b17","series-title":"Med J Aust","first-page":"201","article-title":"Cerebral histoplasmosis in an Australian patient with systemic lupus erythematosus","volume":"169","author":"Sullivan","year":"1998"},{"key":"b18","series-title":"Arch Intern Med","first-page":"217","article-title":"Meningoencephalitis caused by Histoplasma capsulatum: Occurrence in a renal transplant recipient and a review of the literature","volume":"136","author":"Karalakulasingam","year":"1976"},{"key":"b19","series-title":"Neurol Neurocir Psiquiatr","first-page":"403","article-title":"Histoplasma meningitis with common variable hypogammaglobulinemia","volume":"18","author":"Couch","year":"1977"},{"key":"b20","series-title":"Mycopathologia","first-page":"331","article-title":"Primary central nervous system infection by Histoplasma in an immunocompetent adult","volume":"185","author":"de Almeida","year":"2020"},{"key":"b21","series-title":"J Child Neurol","first-page":"532","article-title":"Isolated Histoplasma capsulatum meningoencephalitis in an immunocompetent child","volume":"27","author":"Threlkeld","year":"2012"},{"key":"b22","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"658","article-title":"A case of HIV-associated cerebral histoplasmosis successfully treated with fluconazole","volume":"18","author":"Knapp","year":"1999"},{"key":"b23","series-title":"Pediatr Neurol","first-page":"151","article-title":"Chronic progressive CNS histoplasmosis presenting in childhood: Response to fluconazole therapy","volume":"8","author":"Rivera","year":"1992"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/2\/article-p360.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/2\/article-p360.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/2\/article-p360.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:19:43Z","timestamp":1775841583000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/2\/article-p360.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":46,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0586","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]}}}