Aug 2026· South Dakota medicine : the journal of the South Dakota State Medical Association· Vol 79 8, pp.
350-353
· 0 citations
Medicine
TL;DR
A case of disseminated Coccidioides posadasii infection in a pregnant patient presenting with persistent headache subsequently complicated with coccidioidal meningitis and hydrocephalus requiring neurosurgical intervention is reported.
Sporotrichosis is a mycosis with multitudinous clinical manifestation based on varying factors. We report a 78-year-old man who came to an out-patient clinic for progressive ulcerative cutaneous lesions for 6 months with concurrent pulmonary symptoms and osteomyelitis. Initial investigations were negative for infectious organisms and therapeutic trial of standard anti-tuberculous regimen failed to improve clinical symptoms. Subsequent fungal culture from the ulcerative skin showed dark colonies of Sporothrix schenckii complex. A review of sporotrichosis cases mimicking tuberculosis is provided to demonstrate diagnostic and therapeutic challenges, especially when tuberculosis is endemic.
Natthapong Suthammopasut, Athitaya Luangnara· International Journal of Inf...· 0 citations
Nocardiosis is an uncommon infection that presents as a chronic, debilitating illness with radiographic manifestations simulating lung cancer or tuberculosis. Immunocompromised hosts may develop a fulminant disease resembling acute bacterial pneumonia or disseminated disease. We report a case of a juvenile lupus who developed disseminated Nocardia pseudobrasilienisis infection in form of necrotizing pneumonia, subcutaneous nodules and central nervous system (CNS) lesion in the right parietal lobe, following inadvertent hiking of steroids after a minor organ flare. This case was successfully treated with intravenous meropenem, amikacin, and oral cotrimoxazole therapy for 6 weeks which lead to resolution of pneumonia, and partial resolution of of the cutaneous and CNS lesion. As the patient was immunosuppressed, and had disseminated nocardiosis, we planned to put her on oral cotrimoxazole for the next 1 year.
K. Bhowmick, Angan Karmakar, Dipendranath Ghosh et al.· Lupus· 0 citations
Both Acanthamoeba species and Scedosporium species cause central nervous system infection. They are associated with high mortality and lack clear guidelines with regards to treatment. A co-infection with both organisms, therefore, becomes difficult to diagnose and treat. This case report highlights the presentation of such a co-infection. The importance of looking for an alternate diagnosis in a clinically deteriorating patient with complicated meningoencephalitis using microbiological aids, surgery for the diagnosis and source control of infection along with the challenges associated with managing such a patient are described.
Sanuj Alex Thomas, Ramya Iyadurai, Karthik Gunasekaran et al.· Indian Journal of Medical Mi...· 0 citations
Melioidosis, caused by the gram-negative bacillus Burkholderia pseudomallei - a Tier 1 Select Biological agent - remains a significant cause of severe community-acquired infection in tropical regions, but with recent expanding recognition in temperate climates, including the United States. Pulmonary involvement is the most frequent clinical manifestation, ranging from subclinical nodules to fulminant necrotizing pneumonia and acute respiratory distress syndrome. Despite its clinical severity, melioidosis remains underdiagnosed due to its radiologic mimicry of tuberculosis, broad clinical manifestations, and limited laboratory capacity in many endemic areas. Special Operations Forces (SOF) participating in field exercises or operations in B. pseudomallei endemic countries are at significantly increased risk of infection. Accordingly, SOF medical providers should maintain a high index of suspicion for melioidosis and be familiar with its clinical recognition, diagnosis, and management.
Chase Goldberg, Akira A. Shishido· Journal of special operation...· 0 citations
Coccidioidomycosis is a fungal infection endemic to the southwestern United States that rarely involves the central nervous system (CNS) as a brain abscess or subdural empyema. These uncommon manifestations can mimic neoplastic or inflammatory lesions, making diagnosis particularly challenging.
We report two cases of disseminated coccidioidomycosis with atypical CNS presentations and imaging findings. In the first case, a patient with pulmonary sarcoidosis presented with a right parietal lesion and subdural empyema initially suspected to represent neurosarcoidosis or bacterial infection. In the second case, a patient with a history of resected CNS glioma developed a ring-enhancing lesion concerning for tumor recurrence. In both cases, the diagnosis of CNS coccidioidomycosis was established only after surgical intervention and histopathological examination. Both patients received prolonged antifungal therapy; however, outcomes differed, with one patient experiencing fatal disease progression and the other demonstrating neurological improvement.
These cases highlight the diagnostic challenges of atypical CNS coccidioidomycosis and emphasize the importance of maintaining a high index of suspicion in endemic regions, particularly when imaging findings resemble neoplastic or inflammatory lesions. Early tissue diagnosis and multidisciplinary management are essential, and further studies are needed to optimize treatment strategies for these rare CNS manifestations.
Dana Saleh, Ashley Carter, Avery Roe et al.· Surgical neurology internati...· 0 citations
Coccidioidomycosis (CM) is an emerging fungal infection caused by Coccidioides immitis and C. posadasii, primarily affecting semi-arid regions of the Americas. While pulmonary disease is most common, central nervous system (CNS) involvement—particularly chronic cerebral CM—is rare and presents significant diagnostic and therapeutic challenges. We describe a 64-year-old male from Mexico City with a history of type 2 diabetes and hypertension, who had previously lived and worked for four decades in Salinas, California, an endemic region for CM. Twelve years earlier, he was diagnosed with cerebral CM, treated with intravenous amphotericin followed by oral fluconazole, but prematurely discontinued therapy. He subsequently required placement of a ventriculoperitoneal shunt. He presented with acute neurological decline, including somnolence, gait instability, urinary incontinence, and confusion. Neuroimaging revealed hydrocephalus, prompting shunt revision. CSF cultures confirmed C. posadasii reactivation. CNS involvement in CM, though uncommon, can lead to severe complications such as hydrocephalus and arachnoiditis. Reactivation of CM is a concern, especially in immunocompromised individuals. This case underscores the importance of long-term management and monitoring in patients with CNS CM, particularly those with underlying comorbidities. Chronic CNS coccidioidomycosis requires sustained antifungal treatment and vigilant follow-up to prevent reactivation and associated complications. Increased clinical awareness and early intervention are essential, particularly in endemic areas.
Iván González Godínez, Aurora del Socorro Lunar Téllez, Maria de la Luz Monroy Rovalo et al.· LATAM Revista Latinoamerican...· 0 citations
