Deep Solitary Brain Mass in a Four‐Month‐Old Male with Disseminated Coccidioidomycosis

Nolt, Jennifer D.; Geertsma, Francesca R.

doi:10.1196/annals.1406.006

Cited by 3 publications

(4 citation statements)

References 11 publications

(20 reference statements)

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“…The usual practice is to continue treatment for a minimum of 1‐year after diagnosis 5,15 . However, as in human patients with Coccidioides meningitis, azole therapy is often continued for longer because of the risk for relapse of disseminated disease after discontinuation of drug administration 6,15,18,23,25 . A finding of this study was the number of dogs that were receiving appropriate doses of compounded fluconazole at the time of the onset of neurological signs.…”

Section: Discussionmentioning

confidence: 97%

“…This differs from the basilar and diffuse meningitis typical in humans with intracranial coccidioidomycosis 11,15,21,22 . Intra‐axial granulomatous mass‐type lesions in the brain in people primarily involve immunosuppressed individuals 18,23 . Unlike in humans, dogs with intra‐axial fungal granulomas might be immunocompetent 1 …”

Section: Discussionmentioning

confidence: 99%

“…In humans, CNS infection typically causes a diffuse or basilar meningitis, while intracranial lesions in dogs are more often focal granulomatous masses 4,6,7,11,15,17 . Although individual case reports of focal intracranial Coccidioides granulomas exist in the human literature, the prevalence of focal brain lesions is rare in people compared to dogs 18 . There remains sparse information available describing the clinical characteristics, magnetic resonance imaging (MRI) findings, and prognosis for dogs with disseminated Coccidioides infection involving the CNS 1,15 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, magnetic resonance imaging features, treatment, and outcome for presumed intracranial coccidioidomycosis in 45 dogs (2009‐2019)

Kelley¹,

Stainback²,

Knowles³

et al. 2021

Veterinary Internal Medicne

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Background Knowledge of the clinical and magnetic resonance imaging (MRI) features of intracranial Coccidioides infection in dogs is essential for prompt diagnosis to limit disease‐associated morbidity and death. Objectives To describe the MRI appearance of intracranial coccidioidomycosis in dogs, identify associated clinical and clinicopathologic findings, and report outcomes of medical treatment. Animals Forty‐five client‐owned dogs with presumed intracranial Coccidioides infection. Methods Retrospective case series. Medical records and images were reviewed. Clinical history, examination findings, serology, imaging characteristics, treatment, and outcome were recorded. Included cases had an abnormal brain MRI and positive Coccidioides serology by agar‐gel‐immunodiffusion (AGID). Results Median age was 7‐years. Generalized tonic‐clonic seizures were the most common presenting sign (25/45). Two lesion categories were identified: a granulomatous form with 1 or more distinct, intra‐axial, contrast‐enhancing foci (37/45), and a second variation with diffuse, bilateral, symmetrical lesions of the caudate nuclei and frontal lobes (8/45). Serum IgG titers ranged from 1 : 1 to ≥ 1 : 256; 2 dogs had positive IgM titers at 1 : 2. All dogs with follow‐up serology (34/45) had a reduction in titer. Mean duration of follow‐up was 22.4 ± 20.5 months (median 16 months). Six dogs were lost to follow‐up <1‐year after diagnosis (median 9 months). Five dogs were clinically well but had yet to be followed for >1‐year. Of the remaining 34 dogs, 28 (82%) were alive ≥ 1‐year after diagnosis. Thirteen of these dogs had follow‐up times ≥ 2‐years. Conclusions and Clinical Importance The prognosis for intracranial Coccidioides infection is generally more favorable with medical treatment than in earlier reports.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, magnetic resonance imaging features, treatment, and outcome for presumed intracranial coccidioidomycosis in 45 dogs (2009‐2019)

Kelley¹,

Stainback²,

Knowles³

et al. 2021

Veterinary Internal Medicne

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“…A study among the American Indian population found that children under the age of 5 years and adults older than 50 years were significantly more susceptible to disseminated coccidioidomycosis (Sievers, 1974). Paediatric cases of disseminated coccidioidomycosis involving the brain, spine, gallbladder and soft tissue have been reported (Nolt & Geertsma, 2007;Sydorak et al, 2001;Wrobel et al, 2001). Here, we present a fatal case of disseminated coccidioidomycosis in a 2-month-old infant with unclear route of infection.…”

Section: Introductionmentioning

confidence: 88%

An unanticipated case of disseminated coccidioidomycosis

et al. 2016

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Introduction: Coccidioidomycosis is commonly associated with mild symptoms, and disseminated disease is rare in healthy individuals. Case Presentation: A 2-month-old male presented for further management of Stenotrophomonas maltophilia pneumonia. Respiratory and blood cultures showed a yeast-like growth that was later identified and confirmed as Coccidioides species. Conclusion: We present a fatal case of disseminated coccidioidomycosis in a 2-month-old infant with unclear exposure and mode of transmission. The diagnosis of coccidioidomycosis may have been complicated by the premature diagnosis of Stenotrophomonas maltophilia, highlighting the importance of further investigation into co-infection or alternative pathogens when patients do not respond to initial therapy.

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A Single-center Experience of Coccidioides Meningitis in Immunocompetent Patients: Case Series and Literature Review

Rajmohan,

Deyell,

Harris

et al. 2024

Open Forum Infectious Diseases

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Recently, the California Department of Public Health issued an advisory related to the substantial rise in Coccidioidomycosis in California, which has been attributed in part to climate change and rapid housing development. Most cases are self-limiting, but some may spread to the meninges, resulting in coccidioidal meningitis (CM). Many providers mistakenly presume that CM is limited to patients who are immunocompromised. In this case series and literature review, we present 12 cases of CM in immunocompetent individuals seen at a single tertiary academic center between January 1, 2019-December 31, 2023. All 12 cases developed complications with 10 requiring ventriculoperitoneal shunting, 6 having spinal cord involvement (5 with cervical spine involvement), 4 having strokes, and 3 passing from complications related to CM. It is important to recognize CM as it may be life-threatening if not promptly diagnosed.

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Deep Solitary Brain Mass in a Four‐Month‐Old Male with Disseminated Coccidioidomycosis

Cited by 3 publications

References 11 publications

Clinical characteristics, magnetic resonance imaging features, treatment, and outcome for presumed intracranial coccidioidomycosis in 45 dogs (2009‐2019)

Clinical characteristics, magnetic resonance imaging features, treatment, and outcome for presumed intracranial coccidioidomycosis in 45 dogs (2009‐2019)

An unanticipated case of disseminated coccidioidomycosis

A Single-center Experience of Coccidioides Meningitis in Immunocompetent Patients: Case Series and Literature Review

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