A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up

Abstract

Coccidioides meningoencephalitis is a central nervous system (CNS) fungal infection withCoccidioides species which can lead to various CNS complications, such as hydrocephalus,vasculitis, and stroke. Most cases reported with Coccidioides meningoencephalitis were inimmunocompromised patients, and the radiologic characteristics on this condition are not wellestablished. Here we report a case of Coccidioides meningoencephalitis in an immunocompetentpatient with one-year follow-up brain magnetic resonance image (MRI) studies after successfultreatment with antifungal drugs. The MRI demonstrated subcortical parenchymal lesions,selectively involving the white matter, and persistent meningeal enhancement.

Coccidioidomycosis Meningitis in an Immunocompetent Worker: A Case Report

“…to the central nervous system causing meningitis. 3 CNS coccidioidomycosis occurs when coccidological spherules or endospores migrate to the meninges or into brain tissue. In an early study of 35 autopsy cases, central nervous system coccidioidomycosis was noted to have a predilection for the basilar portion of the brain; pathologic finding observed were thickened, hyperemic meninges , endarteritis obliterans with inflammatory cells throughout the outer layers of small arteries and arterioles with focal necrosis, inflammatory exudates and infarcts, principally of the basal ganglia, thalamus, and white matter and thickened spinal cord meninges with granulomatous inflammation.…”