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Coccidioidal Meningitis in a Patient With HIV
Patrick M Byrne1, Sanjay Shrestha1
1Family Medicine Alexandria, Louisiana State University Health Sciences Center, Alexandria, USA.
Coccidioidal meningitis, a severe Coccidioides infection complication, can affect immunocompromised individuals. Early consideration is vital for patients with HIV and geographic exposure to this fungal pathogen.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Coccidioidal meningitis is a rare but serious complication of disseminated Coccidioides infection.
- It primarily impacts immunocompromised individuals, particularly those with advanced human immunodeficiency virus (HIV) infection.
Observation:
- A case report details a 27-year-old male with advanced HIV who relocated from an endemic area (Arizona) to a non-endemic area (Louisiana).
- The patient presented with chronic headaches, altered mental status, and weight loss, symptoms suggestive of central nervous system (CNS) involvement.
Findings:
- Cerebrospinal fluid (CSF) analysis identified slow-growing mold consistent with Coccidioides species.
- The diagnosis of coccidioidal meningitis was confirmed, highlighting a CNS manifestation of disseminated fungal infection.
Implications:
- This case underscores the importance of considering fungal meningitis, specifically coccidioidal meningitis, in immunocompromised patients.
- Clinicians should maintain a high index of suspicion for Coccidioides infection in individuals with relevant geographic exposure history, even outside endemic regions.
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