Coccidioidal meningitis complicated by central nervous system vasculitis in a patient with leukemia

Dany Tager; Anne Hatch; Jennifer Segar; Brentin Roller; Mayar Al Mohajer; Tirdad T Zangeneh

doi:10.1016/j.mmcr.2017.03.003

Coccidioidal meningitis complicated by central nervous system vasculitis in a patient with leukemia

Med Mycol Case Rep. 2017 Mar 23:16:8-11. doi: 10.1016/j.mmcr.2017.03.003. eCollection 2017 Jun.

Authors

Dany Tager¹, Anne Hatch², Jennifer Segar³, Brentin Roller⁴, Mayar Al Mohajer⁴, Tirdad T Zangeneh⁴

Affiliations

¹ University of Arizona, College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724, USA.
² Department of Neurology, Banner University Medical Center, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, USA.
³ Department of Medicine, Banner University Medical Center, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, USA.
⁴ Division of Infectious Diseases, Department of Medicine, Banner University Medical Center, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, USA.

Abstract

Central Nervous System (CNS) vasculitis is the most common life-threatening complication of coccidioidal meningitis. It is manifested by cerebral ischemia, hemorrhage, and infarction. We report a case of CNS vasculitis in a patient receiving chemotherapy and review of the literature on coccidioidal meningitis. The patient was treated with combination antifungal therapy and a short course of high dose corticosteroids with a modest improvement in her neurological examination after initiation of steroids.

Keywords: Cerebral vasculitis; Coccidioidal meningitis; Disseminated coccidioidomycosis; Fungal meningitis; Steroid.