Invasion of the central nervous system by Histoplasma capsulatum is a rare occurrence; there have been only 32 cases of this complication reported in the English literature up to 1964, and all of these cases were in non-immunosuppressed patients. With the increase in the number of renal transplants over the past ten years in this country, it might be reasonable to expect to see a greater incidence of this complication in immunosuppressed patients. Histoplasmosis is highly endemic in the states of Indiana, Ohio, Illinois, Kentucky, Missouri, Tennessee, Kansas, and Mississippi. By February 1974, 2,101 renal transplants had been done in these states (figure obtained from the transplant registry, American College of Surgeons), and there were no reports of this complication occurring in any of these patients. In this report we describe the clinical and pathological features of a case of meningoencephalitis caused by Histoplasma capsulatum in a renal transplant patient.
Karalakulasingam R, Arora KK, Adams G, Serratoni F, Martin DG. Meningoencephalitis Caused by Histoplasma capsulatumOccurrence in a Renal Transplant Recipient and a Review of the Literature. Arch Intern Med. 1976;136(2):217-220. doi:10.1001/archinte.1976.03630020071015