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Coccidioides meningoencephalitis is a central nervous system (CNS) fungal infection with Coccidioides species which can lead to various CNS complications, such as hydrocephalus, vasculitis, and stroke. Most cases reported with Coccidioides meningoencephalitis were in immunocompromised patients, and the radiologic characteristics on this condition are not well established. Here we report a case of Coccidioides meningoencephalitis in an immunocompetent patient with one-year follow-up brain magnetic resonance image (MRI) studies after successful treatment with antifungal drugs. The MRI demonstrated subcortical parenchymal lesions, selectively involving the white matter, and persistent meningeal enhancement.

the southwest respiratory and critical care chronicles

A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up