We present a case of central nervous system (CNS) histoplasmosis in a previously healthy adult with hepatitis C (HCV) presenting with neurological symptoms refractory to antifungal therapy and ventriculoperitoneal (VP) shunting 4 months after initial diagnosis. Persistent symptoms were thought to be inflammatory rather than infectious given negative cerebrospinal fluid (CSF) and serum fungal antigens. The patient promptly improved after initiation of corticosteroid therapy. Elevated CSF cytokines and regional enhancement on brain MRI resolved with corticosteroid treatment. This is the first case of Histoplasma-associated post-infectious inflammatory response syndrome (Histo-PIIRS) documented by CSF cytokine reduction in response to corticosteroid therapy.

我们报告一例中枢神经系统 (CNS) 组织胞浆菌病病例，该病例是一名既往健康的丙型肝炎 (HCV) 成人患者，在初步诊断后 4 个月出现抗真菌治疗无效和脑室腹腔 (VP) 分流的神经系统症状。鉴于脑脊液 (CSF) 和血清真菌抗原呈阴性，持续症状被认为是炎症性而非传染性。开始皮质类固醇治疗后，患者迅速好转。脑脊液细胞因子升高和脑 MRI 区域增强通过皮质类固醇治疗得到解决。这是首例组织胞浆菌相关的感染后炎症反应综合征 ( Histo -PIIRS)，通过皮质类固醇治疗导致脑脊液细胞因子减少。