Cureus · 5 authors, 2 centres
This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.
This is a case report of a 26-year-old male hiker from an endemic area who presented with progressive headaches and was diagnosed with chronic coccidioidal meningitis. High-dose oral fluconazole was initiated, resulting in a marked clinical response within 48 hours.
He presented with a three-month history of progressive occipital headaches, shortness of breath, and associated neurological symptoms. Diagnostic workup included an MRI showing leptomeningeal enhancement and acute infarcts, and cerebrospinal fluid analysis revealing lymphocytic pleocytosis, eosinophils, elevated protein, and low glucose. Serology for Coccidioides was positive in serum and cerebrospinal fluid. Empiric antibiotics were discontinued, and high-dose oral fluconazole was started, leading to a marked clinical response within 48 hours. The authors highlight the importance of considering coccidioidal meningitis in endemic areas to prevent severe neurological sequelae.
