Clinical and Laboratory Diagnosis of Central Nervous System Histoplasmosis

A 26-year-old man with a history of idiopathic obstructive hydrocephalus with subsequent right-sided ventriculoperitoneal shunt placement 14 months previously presented with fever and headaches of 3 weeks duration. Review of systems was negative for pulmonary symptoms. The patient was febrile at 103.3°F. Physical examination results were normal without focal neurologic deficits. Head computed tomography revealed hydrocephalus,and cerebrospinal fluid analysis revealed 14 white blood cells,58% lymphocytes,3% neutrophils,glucose 62 mg/100 mL,and protein 34 mg/100 mL. Cerebrospinal fluid was inoculated onto 5% sheep blood agar,chocolate agar,and thioglycolate broth. Cytospin Gram stain showed budding yeast and white blood cells.
The American Journal of Medicine

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