Non-shunt Management of Communicating Hydrocephalus in an Immunocompetent Host With Disseminated Central Nervous System Coccidioidomycosis

Disseminated coccidioidomycosis is associated with significant morbidity and mortality. Involvement of the meninges is often fatal if untreated, typically requiring lifelong antifungal therapy and neurosurgical intervention. We present the case of a young male without any known immunocompromising co...

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Bibliographic Details
Published in:JIM - high impact case reports 2023-01, Vol.11, p.23247096231181060-23247096231181060
Main Authors: Menghani, Sanjay V., Takamatsu, Chelsea L., Ibrahim, Ramzi, Molina, Lupita, Jaswal, Neha, Donovan, Fariba M.
Format: Article
Language:English
Subjects:
Case Report
Central Nervous System - surgery
Coccidioidomycosis - complications
Coccidioidomycosis - diagnosis
Coccidioidomycosis - drug therapy
Fungal infections
Humans
Hydrocephalus
Hydrocephalus - etiology
Male
Meningitis
Meningitis, Fungal - diagnosis
Meningitis, Fungal - drug therapy
Nervous system
Ventriculoperitoneal Shunt
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Summary:Disseminated coccidioidomycosis is associated with significant morbidity and mortality. Involvement of the meninges is often fatal if untreated, typically requiring lifelong antifungal therapy and neurosurgical intervention. We present the case of a young male without any known immunocompromising conditions who opted exclusively for medical management of newly diagnosed coccidioidomycosis meningitis with communicating hydrocephalus and discuss the controversy associated with this approach. This case highlights the importance of shared decision-making between patient and clinician, even if the plan diverges from available guidelines. Furthermore, we discuss clinical considerations in approaching the close outpatient monitoring of patients with central nervous system coccidioidomycosis with hydrocephalus.
ISSN:2324-7096
2324-7096
DOI:10.1177/23247096231181060