Central Nervous System Histoplasmosis After Acute COVID-19 in An Adolescent

Central nervous system histoplasmosis is a serious complication of a common en-- demic mycosis, but it is rare in immunocompetent hosts. SARS-CoV-2 has introduced significant challenges into the healthcare setting with overlapping clinical presenta-- tions that may delay the diagnosis of alternative conditions. Additionally, it may lead to immune dysregulation and increase the risk for secondary infections, including in-- vasive fungal diseases. Limited reports have described disseminated histoplasmosis in adults associated with COVID-19, but none have described central nervous system in-- fection or complications in pediatric patients. We report a case of disseminated histo-- plasmosis involving the central nervous system in a previously healthy 13-year-old male with SARS-CoV-2 infection. An extensive immunological evaluation did not identify an underlying immunodeficiency. We highlight the potential of COVID-19 immune dys-- regulation to contribute to the development or progression of invasive fungal disease.