Ring-enhancing Brain Lesions in a Patient with Advanced Human Immunodeficiency Virus from the Central United States of America

Abstract

Background: Histoplasmosis is an endemic fungus found worldwide. It most commonly causes pulmonary infections. In patients with defects in cellular immunity it can cause disseminated infections including central nervous system infections. Case presentation: We present a case of a 44-year-old with advanced human immunodeficiency virus who presented with neurologic complaints. Magnetic resonance imaging of the brain revealed ring-enhancing brain lesions. He underwent brain biopsy of one of the ring-enhancing lesions and histopathology revealed Histoplasma capsulatum. Conclusion: Ring-enhancing brain lesions due to endemic fungi in patients with advanced HIV are uncommon. Nonetheless, this should remain a diagnostic consideration in endemic areas.