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We present the case of an elder man who was admitted for four months of left progressive hemiparesis with suspected neoplastic etiology. A stereotactic brain biopsy was performed with pathological findings of granulomatous lesions and intracellular fungal structures compatible with histoplasma. Additionally, the patient previously had an orchidectomy because of a testicular mass with a biopsy showing a granulomatous lesion. The HIV test and the viral load were negative, the CD4+ lymphocyte count was below 300 cells/µl and a M. tuberculosis PCR on testicular biopsy was positive. We performed a new CD4+ lymphocyte count after six weeks of diagnosis that once again were below 300 cells/µl, confirming the clinical suspicion of idiopathic T CD4+ lymphocytopenia.
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