Spinal Coccidioidomycosis: A Complication From Medication Noncompliance

Area of Science:

• Mycology
• Infectious Diseases
• Neurology

Background:

• Spinal coccidioidomycosis is a rare manifestation of disseminated coccidioidomycosis.
• Literature suggests a predilection for African American males.
• Coccidioidomycosis meningitis can lead to severe neurological complications.

Observation:

• A young Caucasian female with a history of coccidioidomycosis meningitis presented with bilateral lower extremity weakness.
• The patient had a one-year lapse in antifungal medication.
• Imaging revealed cystic arachnoid formations along the thoracic spine.

Findings:

• Pathology confirmed spinal arachnoiditis with Coccidioides fungal elements.
• This case represents a rare occurrence of spinal coccidioidomycosis in a demographic not typically reported.
• The findings underscore the potential for disseminated disease reactivation after treatment interruption.

Implications:

• This case expands the known demographic profile for spinal coccidioidomycosis.
• It emphasizes the importance of sustained antifungal therapy in patients with disseminated coccidioidomycosis.
• Highlights the need for vigilance in diagnosing spinal complications in patients with a history of coccidioidomycosis meningitis.