Coccidioidomycosis is caused by the dimorphic fungi of the genusCoccidioides(C. immitisandC. posadasii), which are endemic in desert regions of the southwestern United States and Central and South America. (Seeand.)Coccidioidal meningitis will be rev

Clinical Presentation. The clinical presentation of meningitis is protean. The most common symptom is headache. Altered mental status, with or without fever, personality changes, nausea, vomiting, and focal neurological deficits may be additional findings.

Coccidioidal meningitis affects between 200 to 300 persons annually within the endemic area of the United States, with much larger numbers expected in epidemic years. Because this represents a chronic disease for survivors, several thousand patients may be under treatment at any given time

Coccidioidal meningitis is the most severe complication of coccidioidomycosis and results from lymphohematogenous spread from the lung, manifesting as fever, headache, changes in sensorium, malaise, and meningismus. CSF studies typically show 100–500 leukocytes/µL (predominantly lymphocytes), low glucose, and protein >150 mg/dL.

Criteria included 1) clinical presentation with influenza-like signs and symptoms, pneumonia, meningitis, or involvement of bones, joints, or skin; and 2) laboratory confirmation with cultural, histopathologic, or molecular evidence of Coccidioides, or positive serologic test results for coccidioidal IgM (by immunodiffusion, enzyme immunoassay [EIA], latex agglutination, or tube precipitin) or for coccidioidal IgG (by immunodiffusion, EIA or complement fixation).

Coccidioidal meningitis information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues.

"Coccidioidal meningitis affects between 200-300 persons annually within the endemic area of the United States, with much larger numbers expected in epidemic years (Williams, 2007).

Coccidioidal Meningitis Clinical Presentation and Management in the Fluconazole Era Glenn Mathisen, MD, Aaron Shelub, MD, Jonathan Truong, MD, and Christine Wigen, MD, MPH

Coccidioides immitis is a pathogenic fungus that resides in the soil in certain parts of the southwestern United States, northern Mexico, and a few other areas in the Western Hemisphere. [2 Epidemiology. C. immitis, along with its relative C . In a case report of a 23-year-old Black male with HIV and coccidioidal meningitis, combination therapy of amphotericin B and posaconazole led to clinical improvement.

Fluconazole is the preferred medication for coccidioidal meningitis, due to its penetration into CSF. [3] Intrathecal or intraventricular amphotericin B therapy is used if infection persists after fluconazole treatment. [13] Itraconazole is used for cases that involve treatment of infected person's bones and joints. The antifungal medications posaconazole and voriconazole have also been used to treat coccidioidomycosis.