Coccidioides Meningitis: An Unusual Presentation of a Devastating Disease

Coccidioidomycosis, a fungal infection caused by the dimorphic Coccidioides genus, spans from asymptomatic exposure to fatal disseminated disease, most notably meningitis. A patient in a nonendemic area presented with neurologic symptoms and imaging concerning for subarachnoid hemorrhage. Cerebral a...

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Bibliographic Details
Main Authors: Ryan D. Carroll, Dennis G. Delgado, Daniela F. de Lima Corvino
Format: Article
Language:English
Published: American College of Physicians 2022-08-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2022.0313
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Summary:Coccidioidomycosis, a fungal infection caused by the dimorphic Coccidioides genus, spans from asymptomatic exposure to fatal disseminated disease, most notably meningitis. A patient in a nonendemic area presented with neurologic symptoms and imaging concerning for subarachnoid hemorrhage. Cerebral angiogram and cerebrospinal fluid analysis were inconsistent with hemorrhage, and subsequent imaging revealed leptomeningitis. Further history revealed previous travel in endemic regions and laboratory studies confirmed disseminated coccidioidomycosis. This patient case illustrates the importance of obtaining a thorough epidemiologic history and maintaining a high clinical suspicion despite an unusual presentation.
ISSN:2767-7664