Intramedullary histoplasmosis of the thoracic cord as an isolated lesion: A rare case report and literature review.

Background: Disseminated histoplasmosis involving the central nervous system occurs in 5-10% of cases. However, intramedullary spinal cord lesions are extremely rare. Here, 45-year-old female with a T8-9 intramedullary lesion did well following surgical extirpation.

Case Description: For 2 weeks, a 45-year-old female experienced progressive lower back pain, paresthesias, and paraparesis. The magnetic resonance imaging showed an intramedullary expansive lesion at the T8-T9 level that markedly enhanced with contrast. Surgery, consisting of T8-T10 laminectomies performed using neuronavigation, an operating microscope, and intraoperative monitoring, revealed a well-demarcated lesion that proved to be a focus of histoplasmosis; it was readily completely excised.

Conclusion: Surgery is the gold standard for treating spinal cord compression attributed to intramedullary histoplasmosis unresponsive to medical management.