TITLE:
Spinal Cord Compression Caused by Multifocal Histoplasmosis Treated Conservatively: Case Report and Literature Review
AUTHORS:
Dominique N’Dri Oka, Alban Slim Mbende, Daouda Sissoko
KEYWORDS:
Histoplasma duboisii, Bone Multiple Localization, Spinal Cord Compression
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.6 No.1,
January
6,
2016
ABSTRACT: We present the case of a 39-year-old patient admitted for a slow thoracic spinal cord compression syndrome associated with lumbar rachialgia. CT scan and MRI of the thoracic spine showed lysis of T4, T5, T6 and T7 vertebrae, an epiduritis and paravertebral abscesses. CT scan of the lumbar spine demonstrated osteolysis of the left iliac wing with skin invasion. This lesion infiltrated the sacrum and the body of L5. The iliac lesion was biopsied and the analysis revealed a granulomatous osteitis caused by Histoplasma duboisii. The treatment consisted of ketoconazole 400 mg daily for six months. Spinal decompressive surgery was not performed. Following antifungal treatment the patient had satisfying clinical and radiological outcome. After three years’ follow-up, the clinical course was uneventful. The patient had neither symptoms of spinal cord compression nor signs of further localizations.