Case report


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

Dongkwan Jin MD, Juliana Gomez MD

ABSTRACT

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.

Keywords: Coccidioides, Coccidioidomycosis, meningoencephalitis, immunocompetent, MRI

Article citation: Jin D, Gomez J. A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up. The Southwest Respiratory and Critical Care Chronicles 2019:7(28):33–37

From: The Department of Neurology at Texas Tech University Health Sciences Center, Lubbock, Texas

Submitted: 7/22/2018

Accepted: 4/3/2019

Reviewers: Mark Lacy MD, Mirla Avila MD

Conflicts of interest: none

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