Cases reported "Meningitis, Fungal"

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1/6. coccidioidomycosis meningitis with massive dural and cerebral venous thrombosis and tissue arthroconidia.

    To our knowledge we report the first case of meningitis from coccidioides immitis associated with massive dural and cerebral venous thrombosis and with mycelial forms of the organism in brain tissue. The patient was a 43-year-old man with late-stage acquired immunodeficiency syndrome (AIDS) whose premortem and postmortem cultures confirmed C immitis as the only central nervous system pathogenic organism. death was attributable to multiple hemorrhagic venous infarctions with cerebral edema and herniation. Although phlebitis has been noted parenthetically to occur in C immitis meningitis in the past, it has been overshadowed by the arteritic complications of the disease. This patient's severe C immitis ventriculitis with adjacent venulitis appeared to be the cause of the widespread venous thrombosis. AIDS-related coagulation defects may have contributed to his thrombotic tendency.
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keywords = immitis
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2/6. Biofilm on ventriculo-peritoneal shunt tubing as a cause of treatment failure in coccidioidal meningitis.

    We describe a case of recurrent coccidioidal meningitis in which a fungal biofilm on the tip of ventriculo-peritoneal shunt tubing was likely responsible for a 4-year persistence of coccidioides immitis, despite the patient's taking an adequate dosage of fluconazole. Fungal biofilms should be considered as a cause for treatment failure and fungal persistence, especially when artificial prostheses or indwelling catheters are present.
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ranking = 0.25
keywords = immitis
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3/6. Acquisition of coccidioidomycosis at necropsy by inhalation of coccidioidal endospores.

    coccidioidomycosis is accepted as being noncontagious because the infectious arthroconidial form of coccidioides immitis is not produced in humans and other mammalian hosts. However, disseminated coccidioidomycosis developed in a veterinarian who autopsied a horse with disseminated disease but without draining lesions or productive cough. We postulate transmission occurred by inhalation of tissue-phase endospores aerosolized in the course of dissection.
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ranking = 0.25
keywords = immitis
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4/6. Successful use of combination antifungal therapy in the treatment of coccidioides meningitis.

    Coccidioidal meningitis is a highly lethal condition with a high morbidity and relapse rate caused by coccidioides immitis. This case report highlights the difficulty in diagnosing and treating coccidioidal meningitis, and discusses a novel combination antifungal therapy (voriconazole and liposomal amphotericin b), which was used to treat this patient.
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ranking = 58.079921201901
keywords = coccidioides, immitis
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5/6. coccidioidomycosis of the central nervous system: neuropathological and vasculopathic manifestations and clinical correlates.

    infection due to the fungus coccidioides immitis, which is endemic to the southwestern united states, is currently occurring in epidemic proportions. Although it usually presents as a subclinical infection or a mild, self-limited pulmonary infection, disseminated infection can occur, especially in immunosuppressed patients. In patients with disseminated coccidioidomycosis, CNS spread is commonly responsible for significant morbidity and mortality. The neurological presentations of C. immitis infection of the CNS are variable. The spectrum of neuropathological change ranges from meningitis to meningoencephalitis and meningomyelitis with extensive parenchymal destruction, sometimes as a result of an associated endarteritis obliterans. We describe a patient with AIDS who developed CNS coccidioidomycosis, and we report the findings of a clinicopathological analysis of eight patients with fatal CNS coccidioidomycosis who were autopsied at UCLA Medical Center. CNS coccidioidomycosis should be considered in the differential diagnosis of patients with neurological symptoms, especially when they are immunosuppressed and live in regions where the disease is endemic.
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ranking = 0.5
keywords = immitis
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6/6. coccidioides immitis presenting as a hyphal form in cerebrospinal fluid.

    This article reports a case of coccidioides immitis that presented as a hyphal form in a 38-year-old patient. The organism was observed growing exclusively as hyphae in the cerebrospinal fluid by microscopic examination. coccidioides immitis was the only organism cultured. The identification of C immitis was confirmed by both standard culture methods and dna probe studies.
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ranking = 1.75
keywords = immitis
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