Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2006
Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report.
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Gurgel Richard K, Roehm Pamela C, Hansen Marlan R
Аннотация
OBJECTIVE: To report a unique presentation of disseminated histoplasmosis.
STUDY DESIGN: Case report.
SETTING: University hospital, tertiary referral center.
PATIENT: Our patient presented with vertigo, tinnitus, and unilateral hearing loss, and was initially found to have a 5-mm enhancing left internal auditory canal mass, as revealed by a magnetic resonance imaging (MRI) scan. Subsequently, the patient developed multiple focal neurologic deficits.
INTERVENTIONS: Magnetic resonance imaging and treatment with intravenously administered amphotericin B, with subsequent oral administration of itraconazole.
MAIN OUTCOME MEASURES: Clinical presentation and imaging findings of Histoplasmosis involving the cranial nerve VIII.
RESULTS: A subsequent MRI scan revealed enlargement of the initial lesion and multiple parenchymal lesions. Further workup revealed a pulmonary lesion; the diagnosis of disseminated histoplasmosis was made on the basis of bronchoalveolar lavage culture.
CONCLUSION: Infectious processes, including disseminated histoplasmosis, should be considered in the differential of internal auditory canal masses, especially in the setting of rapid progression of symptoms.
STUDY DESIGN: Case report.
SETTING: University hospital, tertiary referral center.
PATIENT: Our patient presented with vertigo, tinnitus, and unilateral hearing loss, and was initially found to have a 5-mm enhancing left internal auditory canal mass, as revealed by a magnetic resonance imaging (MRI) scan. Subsequently, the patient developed multiple focal neurologic deficits.
INTERVENTIONS: Magnetic resonance imaging and treatment with intravenously administered amphotericin B, with subsequent oral administration of itraconazole.
MAIN OUTCOME MEASURES: Clinical presentation and imaging findings of Histoplasmosis involving the cranial nerve VIII.
RESULTS: A subsequent MRI scan revealed enlargement of the initial lesion and multiple parenchymal lesions. Further workup revealed a pulmonary lesion; the diagnosis of disseminated histoplasmosis was made on the basis of bronchoalveolar lavage culture.
CONCLUSION: Infectious processes, including disseminated histoplasmosis, should be considered in the differential of internal auditory canal masses, especially in the setting of rapid progression of symptoms.