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Coccidioidal meningitis.

Royce H Johnson1, Hans E Einstein

  • 1Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA. johnsonr@kernmedctr.com

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 3, 2005
PubMed
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Coccidioidal meningitis, a fungal infection affecting the brain, has impacted residents for over 1500 years. Despite advancements in treatment, high morbidity and mortality rates persist, necessitating a comprehensive review of its features.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Coccidioidomycosis, a fungal infection endemic to the southwestern US and northwestern Mexico, has a history of over 1500 years.
  • The 100th anniversary of disseminated coccidioidomycosis and coccidioidal meningitis highlights the enduring challenge of this disease.
  • Despite decades of treatment with intrathecal amphotericin B and over 10 years of azole therapy, coccidioidal meningitis continues to have unacceptably high morbidity and mortality.

Purpose of the Study:

  • To provide a comprehensive review of coccidioidal meningitis.
  • To discuss the pathogenic, pathophysiologic, clinical, laboratory, radiologic, and therapeutic aspects of the disease.

Main Methods:

  • Literature review of coccidioidomycosis and coccidioidal meningitis.

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  • Synthesis of information on the disease's historical context, clinical presentation, diagnosis, and treatment.

    • Main Results:

    • Coccidioidal meningitis remains a significant health concern with high rates of severe illness and death.
    • Current therapeutic options, while improved, are insufficient to overcome the disease's challenges.
    • A thorough understanding of all disease facets is crucial for effective management.

    Conclusions:

    • Coccidioidal meningitis poses a persistent and severe threat in endemic regions.
    • Further research and improved therapeutic strategies are needed to reduce the high burden of this infection.
    • This review consolidates current knowledge to aid clinicians in managing coccidioidal meningitis.