A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up
Coccidioides meningoencephalitis is a central nervous system (CNS) fungal infection with
Coccidioides species which can lead to various CNS complications, such as hydrocephalus,
vasculitis, and stroke. Most cases reported with Coccidioides meningoencephalitis were in
immunocompromised patients, and the radiologic characteristics on this condition are not well
established. Here we report a case of Coccidioides meningoencephalitis in an immunocompetent
patient with one-year follow-up brain magnetic resonance image (MRI) studies after successful
treatment with antifungal drugs. The MRI demonstrated subcortical parenchymal lesions,
selectively involving the white matter, and persistent meningeal enhancement.
Murthy JM, Sundaram C. Fungal infections of the central
nervous system. Handb Clin Neurol 2014;121:1383–1401.
Galgiani JN, Ampel NM, Blair JE, et al. Coccidioidomycosis.
Clin Infect Dis 2005;41(9):1217–1223.
Johnson RH, Einstein HE. Coccidioidal meningitis. Clin
Infect Dis 2006;42(1):103–107.
Kleinschmidt-DeMasters BK, Mazowiecki M, et al. Coccidioidomycosis
meningitis with massive dural and cerebral
venous thrombosis and tissue arthroconidia. Arch Pathol Lab
Dewsnup DH, Galgiani JN, Graybill JR, et al. Is it ever safe to
stop azole therapy for Coccidioides immitis meningitis? Ann
Intern Med 1996;124(3):305–310.
All articles are published under the Creative Commons Attribution-Non-Commercial License https://creativecommons.org/licenses/by-sa/2.0/