Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)

We present a case of central nervous system (CNS) histoplasmosis in a previously healthy adult with hepatitis C (HCV) presenting with neurological symptoms refractory to antifungal therapy and ventriculoperitoneal (VP) shunting 4 months after initial diagnosis. Persistent symptoms were thought to be...

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Autores principales: Dean, Owen, Anjum, Seher, Hess, Bryan, Hammoud, Dima A., Athas, Deena, Wheat, Joseph, Williamson, Peter R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776302/
https://www.ncbi.nlm.nih.gov/pubmed/33387157
http://dx.doi.org/10.1007/s10875-020-00954-9
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author Dean, Owen
Anjum, Seher
Hess, Bryan
Hammoud, Dima A.
Athas, Deena
Wheat, Joseph
Williamson, Peter R.
author_facet Dean, Owen
Anjum, Seher
Hess, Bryan
Hammoud, Dima A.
Athas, Deena
Wheat, Joseph
Williamson, Peter R.
author_sort Dean, Owen
collection PubMed
description We present a case of central nervous system (CNS) histoplasmosis in a previously healthy adult with hepatitis C (HCV) presenting with neurological symptoms refractory to antifungal therapy and ventriculoperitoneal (VP) shunting 4 months after initial diagnosis. Persistent symptoms were thought to be inflammatory rather than infectious given negative cerebrospinal fluid (CSF) and serum fungal antigens. The patient promptly improved after initiation of corticosteroid therapy. Elevated CSF cytokines and regional enhancement on brain MRI resolved with corticosteroid treatment. This is the first case of Histoplasma-associated post-infectious inflammatory response syndrome (Histo-PIIRS) documented by CSF cytokine reduction in response to corticosteroid therapy.
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spelling pubmed-77763022021-01-04 Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS) Dean, Owen Anjum, Seher Hess, Bryan Hammoud, Dima A. Athas, Deena Wheat, Joseph Williamson, Peter R. J Clin Immunol Original Article We present a case of central nervous system (CNS) histoplasmosis in a previously healthy adult with hepatitis C (HCV) presenting with neurological symptoms refractory to antifungal therapy and ventriculoperitoneal (VP) shunting 4 months after initial diagnosis. Persistent symptoms were thought to be inflammatory rather than infectious given negative cerebrospinal fluid (CSF) and serum fungal antigens. The patient promptly improved after initiation of corticosteroid therapy. Elevated CSF cytokines and regional enhancement on brain MRI resolved with corticosteroid treatment. This is the first case of Histoplasma-associated post-infectious inflammatory response syndrome (Histo-PIIRS) documented by CSF cytokine reduction in response to corticosteroid therapy. Springer US 2021-01-02 2021 /pmc/articles/PMC7776302/ /pubmed/33387157 http://dx.doi.org/10.1007/s10875-020-00954-9 Text en © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Dean, Owen
Anjum, Seher
Hess, Bryan
Hammoud, Dima A.
Athas, Deena
Wheat, Joseph
Williamson, Peter R.
Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)
title Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)
title_full Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)
title_fullStr Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)
title_full_unstemmed Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)
title_short Central Nervous System Histoplasma-Associated Post-infectious Inflammatory Response Syndrome (Histo-PIIRS)
title_sort central nervous system histoplasma-associated post-infectious inflammatory response syndrome (histo-piirs)
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776302/
https://www.ncbi.nlm.nih.gov/pubmed/33387157
http://dx.doi.org/10.1007/s10875-020-00954-9
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