“…Over the last 25 years, there has been an increased incidence of disseminated coccidioidomycosis of varying manifestations in hosts without known immunocompromise, from tenosynovitis to meningitis with resultant hydrocephalus. 1 - 4 Presenting symptoms of coccidioidomycosis meningitis include progressively worsening headaches, nausea, vomiting, visual deficits, and mental status changes with fewer traditional meningeal signs like nuchal rigidity. 5 , 6 In addition to antifungal therapy, standard of care for coccidioidomycosis meningitis with symptomatic hydrocephalus includes neurosurgical intervention for definitive management of increased intracranial pressure (ICP).…”