Spinal Coccidioidomycosis: A Complication From Medication Noncompliance

Sakya, Surav M; Sakya, Judy; Hallan, David R; Warraich, Irfan

doi:10.7759/cureus.9304

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…3 It is commonly referred to as Valley fever and is endemic to the southwestern region of the United States. 2 Typically, the disease presents as pneumonia, with which our patient did originally present. Most patients who are immunocompetent have a self-limiting course; however immunocompromised patients, such as ours, are at a higher risk for extrapulmonary disease, such as meningitis.…”

Section: Discussionmentioning

confidence: 78%

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Rare case of syringohydromyelia expansion after kyphotic cervical deformity correction in a patient with history of spinal coccidiomeningitis

et al. 2023

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Syringomyelia resulting from arachnoiditis due to disseminated coccidioidomycosis meningitis has been previously established in the literature. Worsening syringomyelia after kyphotic cervical deformity correction in a patient with spinal coccidioidomycosis, however, has not yet been reported. Herein we present an extremely rare case of disseminated coccidioidomycosis with cystic cervical lesions and an associated syrinx which, after undergoing cervical kyphotic deformity correction in the setting of iatrogenic loss of cervical lordosis, experienced acute syrinx expansion requiring urgent syringosubarachnoid shunt. To our understanding, this is the first case reported of such an event.

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Section: Discussionmentioning

confidence: 78%

“…Spinal coccidioidomycosis is rare and caused by systemic dissemination of the Coccidioides species. 2 In about 1% of infections, extrapulmonary disease including the spine can occur. 3 It is commonly referred to as Valley fever and is endemic to the southwestern region of the United States.…”

Section: Discussionmentioning

confidence: 99%

Rare case of syringohydromyelia expansion after kyphotic cervical deformity correction in a patient with history of spinal coccidiomeningitis

et al. 2023

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Spinal Arachnoiditis in Patients with Coccidioidomycosis Meningitis—Analysis of Clinical and Imaging Features

Sivasubramanian¹,

Kadakia

Kim³

et al. 2022

JoF

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Background: Coccidioidomycosis meningitis (CM) is the most aggressive form of coccidioidomycosis, requiring lifelong antifungal treatment and often cerebrospinal fluid (CSF) diversion. Long-standing CM can be associated with spinal complications such as arachnoiditis. However, studies describing the frequency, clinical, and imaging characteristics of arachnoiditis in patients with CM are limited. Methods: We identified 133 patients with CM based on CSF culture, PCR, or serology between January 2010 and December 2020. Of these, 37 patients underwent spinal imaging. Data on demographics, risk factors, symptoms, antifungal therapy, surgical management, follow-up visits, adherence, serological trends, and imaging findings were reviewed. Results: Abnormal findings were observed in 30 of the 37 patients with CM who underwent spinal imaging. The imaging abnormalities noted in our study included leptomeningeal enhancement (53%), arachnoiditis (53%), syringomyelia (23%), cord signal abnormalities (10%), and osteomyelitis (7%). Of the 30 patients, 90% had symptoms, such as weakness, numbness, or urinary retention. The incidence of arachnoiditis in the present study was 12%. Higher initial CSF protein levels and intra cranial pressure were associated with a higher risk of developing arachnoiditis/syringomyelia. Management of CM was challenging, as evidenced by shunt failure (46%), medication non-compliance (57%), and lack of adequate follow-up (60%). Persistent disabilities were noted in 62% of the patients. Conclusions: Patients with CM develop spinal complications such as arachnoiditis, or syringomyelia. Many cases may go undetected due to lack of symptoms in early stages. CM management challenges such as shunt failure, lack of follow-up care, and medication noncompliance, were frequent.

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Spinal Coccidioidomycosis: A Complication From Medication Noncompliance

Cited by 2 publications

References 5 publications

Rare case of syringohydromyelia expansion after kyphotic cervical deformity correction in a patient with history of spinal coccidiomeningitis

Rare case of syringohydromyelia expansion after kyphotic cervical deformity correction in a patient with history of spinal coccidiomeningitis

Spinal Arachnoiditis in Patients with Coccidioidomycosis Meningitis—Analysis of Clinical and Imaging Features

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