Objective: The purpose of this study was to evaluate the prevalence and significance of concurrent coccidioidal brain and intraspinal disease.
Materials and methods: We conducted a retrospective imaging review of 23 patients with proven coccidioidal CNS meningitis.
Results: All patients had intracranial abnormalities, and 86% (19/22) who underwent spinal imaging had signs of intraspinal disease, including leptomeningeal enhancement (84%), arachnoiditis (63%), and cord signal abnormalities (37%); seven of 15 patients (47%) who underwent myelography had complete spinal blocks.
Conclusion: The high prevalence of concurrent brain and intraspinal coccidioidomycosis supports a low threshold for spinal imaging.