Central nervous system histoplasmosis in a Puerto Rican

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Abstract
The history of a 4-year-old Puerto Rican boy with neurologic symptoms and positive spinal fluid culture for Histoplasma capsulatum is presented because of several unusual characteristics. His case is one of the few reported of clinical histoplasmosis of the central nervous system and possibly represents the only reported primary involvement of the central nervous system. This case is also one of the few reported of clinical histoplasmosis of any type in a Puerto Rican. Success in isolating the etiologic fungus from the patient''s spinal fluid is attributable to the use of yeast extract and thiamine as enrichments on the Sabouraud''s glucose agar. A search for H. capsulatum in soil and animal excreta of the patient''s environment in Puerto Rico proved negative.