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Published on: June 2, 2014
Mistaken for migraine: Coccidioidal meningitis
Anna Morgan1, Stephen James Hoyt, Jamie Park
1At the time this article was written, Anna Morgan was a student in the PA program at the University of North Texas Health Science Center (UNT HSC) in Fort Worth, Tex. She now practices in urgent care at Dignity Health-Mercy Medical Group in Sacramento, Calif. Stephen James Hoyt is a hospitalist at the John Peter Smith Hospital in Fort Worth. Jamie Park practices in emergency medicine and is an assistant professor in the PA program at UNT HSC. Vic Holmes is an associate professor in the PA program at UNT HSC, specializes in the field of family medicine, and is chair of the North Texas Regional Institutional Review Board. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Coccidioidomycosis, a fungal infection, is increasing. Early diagnosis of coccidioidal meningitis in patients with altered mental status is crucial for effective treatment and improved outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Coccidioidomycosis incidence is rising.
- Altered mental status can be a presenting symptom.
- Migraine history may complicate diagnosis.
Purpose of the Study:
- To report a case of coccidioidal meningitis.
- To highlight diagnostic challenges.
- To emphasize the importance of early recognition.
Main Methods:
- Case presentation of a patient with altered mental status.
- Cerebrospinal fluid analysis for diagnosis.
- Initiation of antifungal therapy.
Main Results:
- Diagnosis of coccidioidal meningitis confirmed.
- Patient required lifelong antifungal treatment.
- Early identification can prevent severe complications.
Conclusions:
- Clinician awareness is vital for prompt diagnosis.
- Timely treatment reduces morbidity and mortality.
- Coccidioidal meningitis requires long-term management.
