Histoplasmose do sistema nervoso central. Aspectos clínicos em oito pacientes / Histoplasmosis of the central nervous system. Clinical aspects in 8 patients]

ABSTRACT

Clinical approach has been made in eight patients with histoplasmosis of the central nervous system. All patients had no evidence of immunodepression. Time disease at diagnosis ranged from 6 to 108 months (median 36 months). Main signs and symptoms were intracranial hypertension in 6 patients; impairment of memory in 4; confusion in 4; seizures in 2; urinary incontinence in 2; sexual impotency in 1. Meningo-encephalitic form was present in 6 patients, while the granulomatous form was found in 2. Diagnostic confirmation was based on biopsy, in 1 case; necropsy, in 2 cases; cerebrospinal fluid (CSF) sediment culture, in 1; detection of antibodies against Histoplasma capsulatum in the CSF, in 5 cases. There was, in all patients, an expressive difference between CSF alterations (intense, merging acute and chronic phase elements) and clinical symptomatology (patients in general oligosymptomatic).