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Published on: July 24, 2016
Vasculitic complications associated with coccidioidal meningitis
1Visalia Medical Clinic, Inc., Visalia, CA 93291-5114, USA. pwilliam@pol.net
Seminars in Respiratory Infections
|December 12, 2001
Summary
Coccidioidal meningitis can cause vasculitis, an inflammation of blood vessels, with two distinct types observed. Research is ongoing to understand its causes and develop effective treatments for this serious complication.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Coccidioidal meningitis is an infection of the brain's lining caused by the fungus Coccidioides.
- Vasculitis, or blood vessel inflammation, is an increasingly recognized complication of coccidioidal meningitis.
- Predisposing clinical factors for this vasculitis remain unclear.
Purpose of the Study:
- To review the histopathology and potential pathogenesis of vasculitis in coccidioidal meningitis.
- To discuss the current understanding of this complication and potential therapeutic avenues.
Main Methods:
- Review of existing literature on coccidioidal meningitis and associated vasculitis.
- Description of histological findings in two types of vascular inflammation.
- Discussion of postulated virulence factors and a newly developed rabbit model.
Main Results:
- Two histological patterns of vasculitis are described: early transmural inflammation and chronic intimal thickening.
- Potential virulence factors include metalloproteinases, tumor necrosis factor-alpha (TNF-alpha), and elastase.
- A rabbit model mimics human disease, showing parallels with temporal arteritis.
Conclusions:
- Coccidioidal vasculitis presents distinct pathological features and requires further investigation.
- Established therapies are lacking, and corticosteroid use is debated.
- Agents like omega-3 oils and pentoxyfylline warrant consideration for blocking pathological processes.
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