From the Guidelines
Histoplasmosis does not typically cause paresthesia, or electric shock sensations, and if experienced, these symptoms are likely unrelated to the fungal infection or could represent a rare neurological complication of disseminated histoplasmosis. The primary symptoms of histoplasmosis include respiratory issues such as cough, fever, fatigue, and chest pain, as outlined in the practice guidelines for the management of patients with histoplasmosis by the Infectious Diseases Society of America 1. In severe cases where histoplasmosis disseminates throughout the body, it can affect the nervous system, but this typically manifests as meningitis or focal brain lesions rather than paresthesia.
Key points to consider in the management of histoplasmosis include:
- The use of antifungal medications such as itraconazole (200 mg once or twice daily for 12–24 months) as the treatment of choice for chronic pulmonary histoplasmosis 1.
- Amphotericin B (50 mg daily, or about 0.7 mg/kg/d) is recommended for patients requiring hospitalization due to ventilatory insufficiency, general debilitation, or those who cannot tolerate itraconazole 1.
- Electric shock sensations, or paresthesia, are more commonly associated with conditions like multiple sclerosis, nerve compression, vitamin B12 deficiency, or medication side effects, and require separate evaluation and treatment based on their specific cause.
Given the information provided, there is no direct link established between histoplasmosis and paresthesia in the context of the provided evidence. Therefore, if a patient with histoplasmosis experiences paresthesia, it is crucial to seek immediate medical evaluation to determine the cause of these symptoms and provide appropriate treatment, as they are likely unrelated to the histoplasmosis infection itself 1.
From the Research
Relationship between Histoplasmosis and Paresthesia
There is limited information available on the relationship between histoplasmosis and paresthesia (electric shock sensation). However, some studies provide insight into the neurological manifestations of histoplasmosis:
- Histoplasmosis can cause disseminated disease in immunocompromised individuals, manifesting as multi-system involvement including pulmonary and/or neurological disease 2.
- A case study reported a patient with disseminated histoplasmosis who presented with primary adrenal insufficiency and numerous pulmonary and neurological derangements, but paresthesia was not specifically mentioned 2.
- Another study described a case of reactivation disseminated histoplasmosis in an immunocompetent patient who presented with stroke-like symptoms, including progressive falls, impaired speech, hand tremor, confusion, and generalized weakness, but paresthesia was not reported 3.
- None of the studies provided a direct link between histoplasmosis and paresthesia, suggesting that more research is needed to understand the relationship between the two conditions.
Neurological Manifestations of Histoplasmosis
Some studies highlight the neurological manifestations of histoplasmosis:
- Histoplasmosis should be considered in the differential diagnosis of patients who present with chronic meningitis, cerebral vascular accident, focal brain or spinal cord lesions, and encephalitis 3.
- A case study reported a patient with disseminated histoplasmosis who presented with neurological derangements, including confusion and generalized weakness, but the specific symptoms of paresthesia were not mentioned 2.
- The treatment of choice for severe histoplasmosis is amphotericin B, while itraconazole is given for mild to moderate histoplasmosis, and isavuconazole may be considered in cases where first-line and second-line therapies have failed or are contraindicated 4, 5.