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Active Histoplasma Meningitis of 22 Years' Duration

Jeffrey A. Gelfand, MD; John E. Bennett, MD
JAMA. 1975;233(12):1294-1295. doi:10.1001/jama.1975.03260120056022.
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HISTOPLASMA meningitis without infection of other organs is an exceedingly rare disease. We have had the opportunity to follow-up a case of Histoplasma meningitis, previously reported 11 years ago,1 that has now been active for 22 years without major sequelae, a degree of chronicity unique for meningeal infection due to any cause. This case suggests that histoplasmosis that is confined clinically to the meninges may follow a much more chronic course than Histoplasma meningitis with other organ involvement.

Report of a Case  A 58-year-old man was first hospitalized in 1952 for severe headaches. Lumbar puncture and analysis of cerebrospinal fluid (CSF) disclosed an elevated protein level, lymphocytosis, and hypoglycorrhachia. Cultures on this and on subsequent admissions were negative until 1959, when culture of 30 ml of CSF, removed during pneumoencephalography, was positive for Histoplasma capsulatum. Physical examination, roentgenograms, and cultures from multiple sites, including sputum, blood, urine, and bone


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