Document Detail


Central nervous system abscesses due to Coccidioides species.
MedLine Citation:
PMID:  8838179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Meningitis occurs in one-third to one-half of patients with disseminated coccidioidomycosis, but mass lesions have rarely been described; these lesions are usually found at autopsy. We report six cases of disseminated coccidioidomycosis with central nervous system (CNS) abscesses. Four patients had cerebellar involvement, and two had spinal cord involvement. Four patients were diabetic, and two subsequently died. Review of the literature on CNS coccidioidomycosis indicated that parenchymal brain involvement occurs in 1%-33% of cases, and < 40 cases with mass lesions have been reported since 1905. Almost all patients were male and had other active disseminated foci of coccidioidomycosis. In approximately one-third of all cases, meningitis was absent. Brain lesions may be superficial or deep and multiple or single. In the absence of meningitis, serology of cerebrospinal fluid is negative. Hematogenous origin appears to be more common than direct extension from the meninges. Spinal cord involvement is rare. Diabetes was present in several cases, thus suggesting a vascular predisposition. We hope our experience will increase awareness of this entity, which appears to be more common than previously appreciated, and will facilitate diagnosis.
Authors:
A F Bañuelos; P L Williams; R H Johnson; S Bibi; D N Fredricks; S A Gilroy; S U Bhatti; J Aguet; D A Stevens
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  22     ISSN:  1058-4838     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-12-03     Completed Date:  1996-12-03     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  240-50     Citation Subset:  IM    
Affiliation:
Department of Medicine, Santa Clara Valley Medical Center, San Jose, California 95128-2699, USA.
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MeSH Terms
Descriptor/Qualifier:
Abscess* / microbiology,  pathology
Adolescent
Adult
Brain Abscess* / microbiology,  pathology
Cerebellar Diseases* / microbiology,  pathology
Cerebellum / microbiology,  pathology
Child, Preschool
Coccidioides / isolation & purification
Coccidioidomycosis* / microbiology,  pathology
Female
Humans
Male
Middle Aged
Spinal Cord / microbiology,  pathology
Spinal Cord Diseases* / microbiology,  pathology

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