A case report of Coccidioides posadasii meningoencephalitis in an immunocompetent host

dc.contributor.authorLang, Raynell
dc.contributor.authorStokes, William
dc.contributor.authorLemaire, Jane
dc.contributor.authorJohnson, Andrew
dc.contributor.authorConly, John
dc.date.accessioned2019-08-18T00:07:16Z
dc.date.available2019-08-18T00:07:16Z
dc.date.issued2019-08-16
dc.date.updated2019-08-18T00:07:15Z
dc.description.abstractAbstract Background Coccidioides spp. are dimorphic fungi endemic to Central America, regions of South America and southwestern USA. Two species cause most human disease: Coccidioides immitis (primarily California isolates) and Coccidioides posadasii. Coccidioidomycosis is typically acquired through inhalation of soil or dust containing spores. Coccidioidal meningitis (CM), most common in the immunocompromised host, can also affect immunocompetent hosts. Case presentation We report a case of C. posadasii meningoencephalitis in a previously healthy 42-year-old Caucasian male who returned to Canada after spending time working in New Mexico. He presented with a 3-week history of headache, malaise and low-grade fevers. He developed progressive confusion and decreasing level of consciousness following hospitalization. Evidence of hydrocephalus and leptomeningeal enhancement was demonstrated on magnetic resonance imaging (MRI) of his brain. Serologic and PCR testing of the patient's CSF confirmed Coccidioides posadasii. Despite appropriate antifungal therapy he continues to have significant short-term memory deficits and has not returned to his full baseline functional status. Conclusions Travel to endemic regions can result in disease secondary to Coccidioides spp. and requires physicians in non-endemic areas to have a high index of suspicion. Effective therapeutic options have reduced the mortality rate of CM, however, it is still associated with significant morbidity and requires life-long therapy.
dc.identifier.citationBMC Infectious Diseases. 2019 Aug 16;19(1):722
dc.identifier.doihttps://doi.org/10.1186/s12879-019-4329-0
dc.identifier.urihttp://hdl.handle.net/1880/110738
dc.identifier.urihttps://doi.org/10.11575/PRISM/45868
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titleA case report of Coccidioides posadasii meningoencephalitis in an immunocompetent host
dc.typeJournal Article
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