Central nervous system histoplasmosis after rhinoplasty

Abstract

One to two weeks after rhinoplasty was performed in a 49-year-old woman, chronic granulomatous meningoencephalitis developed. The disease was characterized by headache, mental changes, ataxia, and persistent CSF pleocytosis with hypoglycorrhachia. Histoplasma capsulatum was isolated from the CSF using Sabouraud9s agar media at a neutral pH with antibiotics added. Isolation using conventional Sabouraud9s agar media at pH 5.6 was unsuccessful. This is the sixth reported case of central nervous system histoplasmosis in the absence of disseminated disease. Further attempts to isolate fungi from the CSF of patients with suspected granulomatous meningoencephalitis should be carried out on both conventional Sabouraud9s agar media and on Sabouraud9s agar media with neutral pH and antibiotics.