Delayed Lower Urinary Tract Symptoms and Erectile Dysfunction after Acute Episode of Coccidioidal Meningitis

We present an interesting case of a 27-year-old male with coccidioidal meningitis who developed permanent erectile dysfunction (ED) and lower urinary tract symptoms 3 months after initiation of therapy. The patient presented to the urology clinic with a complaint of a weak stream, urinary urgency and frequency, as well as enuresis which were only moderately controlled with anti-cholinergics. His ED responded well to phosphodiesterase-5 inhibitors. After an extensive review of the literature, this is the first report of delayed presentation of ED and lower urinary tract symptoms secondary to coccidioidal meningitis.