title: Successful treatment of spinal arachnoiditis due to coccidioidomycosis. Case report.
abstract: An unusual case is reported of a patient with spastic paraparesis who was found to have severe spinal arachnoiditis due to Coccidioides immitis. Despite an obstructive hydrocephalus and a spinal subarachnoid block, the patient was treated effectively with surgery (shunting) and antifungal therapy (amphotericin and ketoconazole). He remains asymptomatic 3 years after diagnosis. Aggressive surgical and medical treatment of coccidioidal infection of the central nervous system can be beneficial, even in patients with the worst prognosis.
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D001100:Arachnoiditis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D003047:Coccidioidomycosis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007654:Ketoconazole; D008297:Male; D010879:Piperazines / Q000627:therapeutic use; D013118:Spinal Cord Diseases / Q000188:drug therapy / Q000601:surgery*
chemical_list: D007093:Imidazoles; D010879:Piperazines; D000666:Amphotericin B; D007654:Ketoconazole