Controversies in the Management of Central Nervous System Coccidioidomycosis

George R Thompson; Neil M Ampel; Janis E Blair; Fariba Donovan; Joshua Fierer; John N Galgiani; Arash Heidari; Royce Johnson; Stanley A Shatsky; Christopher M Uchiyama; David A Stevens

doi:10.1093/cid/ciac478

Controversies in the Management of Central Nervous System Coccidioidomycosis

Clin Infect Dis. 2022 Sep 10;75(4):555-559. doi: 10.1093/cid/ciac478.

Authors

George R Thompson^{1

2}, Neil M Ampel^{3

4}, Janis E Blair³, Fariba Donovan^{4

5}, Joshua Fierer^{6

7}, John N Galgiani^{4

5}, Arash Heidari^{8

9}, Royce Johnson^{8

9}, Stanley A Shatsky¹⁰, Christopher M Uchiyama¹¹, David A Stevens^{12

13}

Affiliations

¹ Department of Internal Medicine, Division of Infectious Diseases and the Department of Medical Microbiology and Immunology, University of California-Davis Medical Center, Sacramento, California, USA.
² University of California-Davis Center for Valley Fever, Sacramento, California, USA.
³ Division of Infectious Diseases, Mayo Clinic in Arizona, Phoenix, Arizona, USA.
⁴ Department of Internal Medicine, Division of Infectious Diseases, University of Arizona College of Medicine, Tucson, Arizona, USA.
⁵ Valley Fever Center for Excellence, University of Arizona College of Medicine-Tucson, Tucson, Arizona, USA.
⁶ Division of Infectious Disease, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA.
⁷ Infectious Diseases Section, VA Healthcare San Diego, San Diego, California, USA.
⁸ Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Kern Medical, Bakersfield, California, USA.
⁹ Valley Fever Institute, Kern Medical Center, Bakersfield, California, USA.
¹⁰ Department of Neurosurgery, Good Samaritan Hospital, San Jose, California, USA.
¹¹ Department of Neurosurgery, Scripps Clinic and Scripps Green Hospital, La Jolla, California, USA.
¹² California Institute for Medical Research, San Jose, California, USA.
¹³ Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.

PMID: 35717645
DOI: 10.1093/cid/ciac478

Abstract

Central nervous system infection with Coccidioides spp. is fatal if untreated and complications occur even when therapy is directed by experienced clinicians. We convened a panel of clinicians experienced in the management of coccidioidal meningitis to summarize current controversies and provide consensus for the management of this difficult infection.

Keywords: Coccidioides; Valley Fever; coccidioidomycosis; intracranial pressure; meningitis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antifungal Agents / therapeutic use
Central Nervous System
Coccidioides
Coccidioidomycosis* / complications
Coccidioidomycosis* / diagnosis
Coccidioidomycosis* / drug therapy
Humans
Meningitis, Fungal* / diagnosis
Meningitis, Fungal* / drug therapy

Substances

Antifungal Agents