Skip to main content

Coccidioidal Meningitis

  • Chapter
Coccidioidomycosis

Part of the book series: Current Topics in Infectious Disease ((CTID))

Abstract

Coccidioidal meningitis (CM) is a lethal, chronic granulomatous disease of the leptomeninges caused by Coccidioides immitis. Untreated CM is uniformly fatal and accounts for the majority of the deaths caused by coccidioidomycosis.1,2,3 However, aggressive treatment with amphotericin B (AMB) reduces mortality and prolongs survival. This chapter will review our current concepts of CM, its diagnosis, and its treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. W. C. Buss, T. E. Gibson, and M. A. Gifford, Coccidioidomycosis of the meninges, Calif. Med. 72: 167–169 (1950).

    PubMed  CAS  Google Scholar 

  2. R. W. Huntington, Jr., Morphology and racial distribution of fatal coccidioidomycosis, J. Am. Med. Assoc. 169: 115–118 (1959).

    Article  PubMed  Google Scholar 

  3. R. W. Huntington, W. J. Waldmann, J A Sargent, H. O’Connell, R. Wybel, and D. Croll, Pathologic and clinical observations of 142 cases of fatal coccidioidomycosis with necropsy, in: Coccidioidomycosis ( L. Ajello, ed.), University of Arizona Press, Tucson (1967), pp. 143–167.

    Google Scholar 

  4. R. G. Caudill, C. E. Smith, J. A. Reinarz, Coccidioidal meningitis: A diagnostic challenge, Am. J. Med. 49: 360–365 (1970).

    Article  PubMed  CAS  Google Scholar 

  5. D. Pappagianis and R. Crane, Survival in coccidioidal meningitis since introduction of amphotericin B, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 223–237.

    Google Scholar 

  6. W. A. Winn, The use of amphotericin B in the treatment of coccidioidal disease, Am. J. Med. 27: 617–635 (1959).

    Article  PubMed  CAS  Google Scholar 

  7. E. C. Dickson and M. A. Gifford, Coccidioides infection (coccidioidomycosis). II. The primary type of infection, Arch. Intern. Med. 62: 853–871 (1938).

    Article  Google Scholar 

  8. E. C. Dickson, Coccidioidomycosis, J. Am. Med. Assoc. 111: 1362–1365 (1938).

    Article  Google Scholar 

  9. W. D. Forbus and A. M. Bestebreutje, Coccidioidomycosis: a study of 95 cases of the disseminated type with special reference to the pathogenesis of the disease, Mil. Surg. 99: 619–653 (1946).

    Google Scholar 

  10. K. H. Abbott and O. I. Cutler, Chronic coccidioidal meningitis, Arch. Pathol. 21: 320–330 (1936).

    Google Scholar 

  11. F. E. Jackson, D. Kent, and F. Clare, Quadriplegia caused by involvement of cervical spine with Coccidioides immitis, J. Neurosurg. 21: 512–515 (1964).

    Article  PubMed  CAS  Google Scholar 

  12. S. D. Ingham, Coccidioidal granuloma of the spine with compression of the spinal cord, Bull. Los Angeles Neurol. Soc. 1: 41–49 (1936).

    Google Scholar 

  13. C. W. Rand, Coccidioidal granuloma, Arch. Neurol. Psychiatry 23: 502–511 (1930).

    Article  Google Scholar 

  14. M. L. Gottlieb, Coccidioidomycosis localized to the thoracic spinal cord and brain, with a plea for early diagnosis, Ariz. Med. 13: 131–139 (1956).

    PubMed  CAS  Google Scholar 

  15. C. B. Courville and K. H. Abbott, Pathology of coccidioidal granuloma of the central nervous system and its envelopes, Bull. Los Angeles Neurol. Soc. 3: 27–41 (1938).

    Google Scholar 

  16. H. G. Schlumberger, A fatal case of cerebral coccidioidomycosis with cultural studies, Am. J. Med. Sci. 209: 483–496 (1945).

    Article  Google Scholar 

  17. A. E. Rhoden, Coccidioidal brain abscess, Bull. Los Angeles Neurol. Soc. 11: 80–85 (1946).

    PubMed  CAS  Google Scholar 

  18. D. M. Goldstein and J. B. McDonald, Primary pulmonary coccidioidomycosis, J. Am. Med. Assoc. 124: 557–561 (1944).

    Article  Google Scholar 

  19. C. E. Smith, R. R. Beard, E. G. Whiting, and H. G. Rosenberger, Varieties of coccidioidal infection in relation to the epidemiology and control of the diseases, Am. J. Public Health 36: 1394–1402 (1946).

    Article  CAS  Google Scholar 

  20. C. E. Smith, M. T. Saito, R. R. Beard, R. M. Kepp, R. W. Clark, and B. U. Eddie, Serological tests in the diagnosis and prognosis of coccidioidomycosis, Am. J. Hyg. 52: 1–21 (1950).

    PubMed  CAS  Google Scholar 

  21. P. C. Kelly, M. L. Sievers, R. Thompson, and C. Echols, Coccidioidal meningitis: results of treatment in 22 patients, in: Coccidioidomycosis, Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 239–251.

    Google Scholar 

  22. E. Rosen and J. P. Belber, Coccidioidal meningitis of long duration, Ann. Intern. Med. 34: 796–809 (1951).

    Article  PubMed  CAS  Google Scholar 

  23. W. A. Winn, Coccidioidal meningitis: A follow-up report, in: Coccidioidomycosis ( L. Ajello, ed.), University of Arizona Press, Tucson (1967), pp. 55–62.

    Google Scholar 

  24. D. L. Reeves and C. F. Baisinger, Primary chronic coccidioidal meningitis: A diagnostic neurosurgical problem, J. Neurosurg. 2: 269–280 (1945).

    Article  Google Scholar 

  25. S. C. Deresinski and D. A. Stevens, Coccidioidomycosis in compromised hosts, Medicine 54: 377–395 (1974).

    Article  Google Scholar 

  26. N. Smithline, D. A. Ogden, A. I. Cohn, and K. Johnson, Disseminated coccidioidomycosis in renal transplant patients, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 201–208.

    Google Scholar 

  27. V. S. Rowland, R. E. Westfall, and W. A. Hinchcliffe, Fatal coccidioidomycosis: analysis of host factors, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 91–106.

    Google Scholar 

  28. H. Einstein, C. W. Holeman, Jr., L. Sandidge, and D. H. Holden, Coccidioidal meningitis, the use of amphotericin B in treatment, Calif. Med. 94: 339–343 (1961).

    PubMed  CAS  Google Scholar 

  29. D. D. Norman and Z. R. Miller, Coccidioidomycosis of the central nervous system, a case of ten years’ duration, Neurology 4: 713–717 (1954).

    Article  PubMed  CAS  Google Scholar 

  30. C. F. Sweigert, H. W. Turner, and J. B. Gillespie, Clinical and roentgenologic aspects of coccidioidomycosis, Am. J. Med. Sci. 212: 652–673 (1946).

    Article  PubMed  CAS  Google Scholar 

  31. V. E. Jenkins and J. C. Postlewaite, Coccidioidal meningitis: report of four cases with necropsy findings in 3 cases, Ann. Intern. Med. 35: 1068–1084 (1951).

    Article  PubMed  CAS  Google Scholar 

  32. F. Unterharnscheidt, M. DeBeukelaer, and J. L. Simon, Chronic untreated coccidioidomycosis of the central nervous system: a case of 7 1/2 years duration, Tex. Rep. Biol. Med. 27: 513–524 (1969).

    PubMed  CAS  Google Scholar 

  33. W. A. Winn, The treatment of coccidioidal meningitis. The use of amphotericin B in a group of twenty-five patients, Calif. Med. 101: 78–89 (1964).

    PubMed  CAS  Google Scholar 

  34. S. C. Deresinski, J N Galgiani, and D. A. Stevens, Miconazole treatment of human coccidioidomycosis: status report, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 267–294.

    Google Scholar 

  35. D. S. Zealear and W. A. Winn, The neurosurgical approach in the treatment of coccidioidal meningitis. Report of 10 cases, in: Coccidioidomycosis ( L. Ajello, ed.), University of Arizona Press, Tucson (1967), pp. 43–53.

    Google Scholar 

  36. D. Pappagianis, N. J. Lindsey, C. E. Smith, and M. T. Saito, Antibodies in human coccidioidomycosis: immunoelectrophoretic properties, Proc. Soc. Exp. Biol. Med. 118: 118–122 (1965).

    PubMed  CAS  Google Scholar 

  37. Y. Sawaki, M. Huppert, J. W. Bailey, and Y. Yagi, Patterns of human antibody reactions in coccidioidomycosis, J. Bacteriol. 91: 422–427 (1966).

    PubMed  CAS  Google Scholar 

  38. R. W. P. Cutler, G. V. Watters, J. P. Hammerstad, and E. Merler, Origin of cerebrospinal fluid gamma globulin in subacute sclerosing leukoencephalitis, Arch. Neurol. 17: 620–628 (1967).

    Article  PubMed  CAS  Google Scholar 

  39. S. Cohen and R. Bannister, Immunoglobulin synthesis within the central nervous system in disseminated sclerosis, Lancet 1: 366–367 (1967).

    Article  PubMed  CAS  Google Scholar 

  40. C. E. Smith, M. T. Saito, and S. A. Simons, Pattern of 39,500 serologic tests in coccidioidomycosis, J. Am. Med. Assoc. 160: 546–552 (1956).

    Article  PubMed  CAS  Google Scholar 

  41. D. Pappagianis, M. Saito, and K. H. Van Hoosear, Antibody in cerebrospinal fluid in non-meningitic coccidioidomycosis, Sabouraudia 10: 173–179 (1972).

    Article  PubMed  CAS  Google Scholar 

  42. E. A. Petersen, B. A. Friedman, E. D. Crowder, and D. Rifkind, Coccidioidouria: clinical significance, Ann. Intern. Med. 85: 34–38 (1976).

    Article  PubMed  CAS  Google Scholar 

  43. M. J. Fiese, Coccidioidomycosis, p. 152, Charles C. Thomas, Springfield, Ill. (1958).

    Google Scholar 

  44. J. J. Ellner and J. E. Bennett, Chronic meningitis, Medicine 55: 341–370 (1976).

    Article  PubMed  CAS  Google Scholar 

  45. W. A. Winn, Coccidioidomycosis, Med. Clin. North Am. 47: 1131–1148 (1963).

    PubMed  CAS  Google Scholar 

  46. M. S. Collins and D. Pappagianis, Uniform susceptibility of various strains of Cocci dioides immitis to amphotericin B, Antimicrob. Agents Chemother. 11: 1049–1055 (1977).

    Article  PubMed  CAS  Google Scholar 

  47. D. D. Bindschadler and J. E. Bennett, A pharmacologic guide to the clinical use of amphotericin B, J. Infect. Dis. 120: 427–436 (1969).

    Article  PubMed  CAS  Google Scholar 

  48. C. W. Holeman and P. Johnson, Long term follow-up of amphotericin treated coccidioidal meningitis patients, Proceedings of the Twenty-First Annual Coccidioidomycosis Study Group, Abstract 1 (1976).

    Google Scholar 

  49. H. E. Einstein, Coccidioidomycosis of the central nervous system, in: Advances in Neurology, Vol. 6 ( R. A. Thompson and J. R. Green, eds.), Raven Press, New York (1974), pp. 101–106.

    Google Scholar 

  50. H. W. Buchsbaum, Clinical management of coccidioidal meningitis, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 191–200.

    Google Scholar 

  51. J. J. Castellot, F. W. Pitts, and F. H. Mowrey, A case of coccidioidal meningitis arrested by prolonged therapy with amphotericin B., Antibiot. Med. Clin. Ther. 6: 480–485 (1959).

    CAS  Google Scholar 

  52. N. P. Alazraki, J. Fierer, S. E. Halpern, and R. W. Becker, Use of a hyperbaric solution for administration of intrathecal amphotericin B, N. Engl. J. Med. 290: 641–646 (1974).

    Article  PubMed  CAS  Google Scholar 

  53. K. P. Glynn, N. P. Alazraki, and T. A. Waltz, Coccidioidal meningitis-intrathecal treatment with hyperbaric Amphotericin B., Calif. Med. 119: 6–9 (1973).

    PubMed  CAS  Google Scholar 

  54. M. LeClerc and S. T. Giammona, Coccidioidal meningitis, the use of amphotericin B intravenously and intrathecally by repeated lumbar punctures, West. J. Med. 122: 251–254 (1975).

    PubMed  CAS  Google Scholar 

  55. J. P. Sung and J. G. Grendahl, Clinical experimental therapy with miconazole for human disseminated coccidioidomycosis, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 293–310.

    Google Scholar 

  56. J. R. Keane, Cisternal puncture complications-treatment of coccidioidal meningitis with amphotericin B, Calif. Med. 119: 10–15 (1973).

    PubMed  CAS  Google Scholar 

  57. A. Underman, Private communication of a paper delivered at the Third International Coccidioidomycosis Symposium, Tucson (1976).

    Google Scholar 

  58. D. L. Kelly, Lateral cervical puncture for myelography, J. Neurosurg. 29: 106–110 (1968).

    Article  PubMed  Google Scholar 

  59. R. A. Ratcheson and A. K. Ommaya, Experience with subcutaneous cerebrospinal-fluid reservoir, preliminary report of 60 cases, N. Engl. J. Med. 279: 1025–1031 (1968).

    Article  PubMed  CAS  Google Scholar 

  60. R. D. Diamond and J. E. Bennett, A subcutaneous reservoir for intrathecal therapy of fungal meningitis, N. Engl. J. Med. 288: 186–188 (1973).

    Article  PubMed  CAS  Google Scholar 

  61. A. J. Atkinson, Jr., and D. D. Bindschadler, Parmacokinetics of intrathecally administered amphotericin B, Am. Rev. Resp. Dis. 99: 917–924 (1969).

    PubMed  CAS  Google Scholar 

  62. E. Goldstein, M. J. Winship, and D. Pappagianis, Ventricular fluid and the management of coccidioidal meningitis, Ann. Intern. Med. 77: 243–246 (1972).

    Article  PubMed  CAS  Google Scholar 

  63. J. P. Utz, J. E. Bennett, M. W. Brandriss, W. T. Butler, and G.J. Hill II, Amphotericin B toxicity, Ann. Intern. Med. 61: 334–354 (1964).

    Article  CAS  Google Scholar 

  64. N. T. Carnevale, J. N. Galgiani, J. W. Langston, and D. A. Stevens, Myelopathy due to intrathecal amphotericin B, in: Coccidioidomycosis: Current Clinical and Diagnostic Status ( L. Ajello, ed.), Symposia Specialists, Miami (1977), pp. 259–260.

    Google Scholar 

  65. N. T. Carnevale, J. N. Galgiani, J. W. Langston, D. A. Stevens, and M. K. Herrick, Amphotericin-induced myelopathy, Neurology 27: 359 (1977).

    Article  Google Scholar 

  66. H. B. Levine, D. A. Stevens, J. M. Cobb, and A. E. Gebhart, Miconazole in coccidioidomycosis. I. Assay of activity in mice andin vitro, J. Infect. Dis. 132: 407–414 (1975).

    Article  PubMed  CAS  Google Scholar 

  67. D. A. Stevens, H. B. Levine, and S. C. Deresinski, Miconazole in coccidioidomycosis. II. Therapeutic and pharmacologic studies in man, Am. J. Med. 60: 191–202 (1976).

    Article  PubMed  CAS  Google Scholar 

  68. S. C. Deresinski, R. B. Lilly, H. B. Levine, J. N. Galgiani, and D. A. Stevens, Treatment of fungal meningitis with miconazole, Arch. Intern. Med. 137: 1180–1185 (1977).

    Article  PubMed  CAS  Google Scholar 

  69. D. A. Stevens, Miconazole in the treatment of systemic fungal infections, Am. Rev. Resp. Dis. 116: 801–806 (1977).

    PubMed  CAS  Google Scholar 

  70. S. H. Cheu and W. J. Waldmann, Unusual complications of ventriculo-atriostomy for communicating hydrocephalus in coccidioidal meningitis, in: Coccidioidomycosis ( L. Ajello, ed.), University of Arizona Press, Tucson (1967), pp. 25–30.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1980 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kelly, P.C. (1980). Coccidioidal Meningitis. In: Stevens, D.A. (eds) Coccidioidomycosis. Current Topics in Infectious Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1712-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-1712-9_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-1714-3

  • Online ISBN: 978-1-4757-1712-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics