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Peer reviewedCoccidioidomycosis

A challenging presentation of central nervous system involvement in disseminated coccidioidomycosis: Insights from cases

Surgical Neurology International·

Dana Saleh, Ashley Carter, Avery Roe, Gilberto Perez Rodriguez Garcia, Giovanni Barbagli, Khalid A. Alsherbini, Robert Bina

DOI
10.25259/sni_613_2025
PMID
PMCID
OpenAlex
Study type
Journal article
Publisher
Scientific Scholar
Article type
journal-article
Integrity
current

Why this research matters now

CNS coccidioidomycosis is rare but challenging to diagnose due to imaging resemblance to malignancy or inflammation, highlighting the need for clinician awareness in endemic areas and early tissue-based diagnosis.

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Structured evidence summary

Research question

The study explored central nervous system (CNS) involvement in disseminated coccidioidomycosis, focusing on diagnostic challenges when atypical presentations mimic neoplastic or inflammatory lesions.

Study design

This is a peer-reviewed case report describing two patients with CNS coccidioidomycosis, diagnosed and managed at a single institution.

Population and setting

Two adult patients with prior pulmonary disease (sarcoidosis) or CNS malignancy (glioma) presented with atypical CNS lesions in what is described as an endemic region for coccidioidomycosis.

Main findings

Both patients required surgical intervention and histopathology to confirm coccidioidal CNS infection. Treatment with prolonged antifungal therapy yielded divergent outcomes: one patient died from disease progression while the other showed neurological improvement.

Public-health relevance

CNS coccidioidomycosis is rare but challenging to diagnose due to imaging resemblance to malignancy or inflammation, highlighting the need for clinician awareness in endemic areas and early tissue-based diagnosis.

Important limitations

This summary is limited to the supplied single-article abstract and metadata. The original paper is required for decision-grade interpretation. Additionally, the case report design with only two patients lacks the statistical power to establish treatment efficacy or generalizable conclusions.

GIDS interpretation

Coccidioidomycosis is noted as endemic to the southwestern United States, where CNS involvement represents an uncommon manifestation. This case series illustrates a diagnostic niche that may be encountered in immunocompromised populations or when imaging findings are atypical.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 7 auditable classifier relationships to diseases, places, topics, and study design.

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