Abstract
OBJECTIVE
Spinal intramedullary histoplasmosis is an extremely rare condition. We report a case of isolated intramedullary histoplasmosis as the initial manifestation of human immunodeficiency virus (HIV) infection.
CLINICAL PRESENTATION
A 27-year-old man presented with a rapidly progressive paraparesis. Magnetic resonance imaging scans revealed an enhancing lesion at C7–T1 with edema extending as far as the cervicomedullary junction. He improved with steroid medications.
INTERVENTION
The patient underwent laminectomy and biopsy of the lesion. The diagnosis of histoplasmosis was made by histology, culture, and polymerase chain reaction identification of fungal deoxyribonucleic acid. The patient did not have disseminated histoplasmosis. Subsequent to the biopsy, the patient was discovered to have HIV infection.
CONCLUSION
The isolated spinal histoplasmosis lesion thus represented the initial presentation of HIV infection. Management of the case and diagnostic issues are discussed.
Stroke-Like Presentation of Toxic Leukoencephalopathy as the Initial Manifestation of HIV Infection
