Intramedullary Spinal Cord Compression Caused by Histoplasma capsulatum: A Case Report and Meta-Analysis

Abstract Nine cases of intramedullar histoplasmosis have been published in the literature. In six cases, spinal cord compression was associated with brain localization or with contex of disseminated histoplasmosis. The authors are reporting here the third isolated spinal cord compression in immunocompetent 42-year-old African-rabbits breeder, a woman. This case was successfully managed with surgical removal of the lesion associated to itraconazole during 8 months. Intramedullar lesion because of the Histoplasma capsulatum was necrosis granulomatous localized at spinal conus. In conclusion, according to literature data the most frequent spinal cord compression caused by histoplasmosis capsulatum. General risk factors include residence in endemic areas as well as immunosuppression. Endemic areas include Africa, Australia, parts of Eastern Asia, and America (Mississippi, Missouri, and Ohio River valleys). Initial localization was cutaneous. Two histopathological forms reported are abscess and necrotizing granuloma. Management is mainly based on antifungus like itraconazole. Surgery is only necessary for the etiology diagnosis.