title: Hyphal forms in the central nervous system of patients with coccidioidomycosis.
abstract: Coccidioides immitis is a dimorphic fungus that grows as a filamentous mold in soil and as a spherule at human body temperature. The hyphal or soil form is found rarely in human tissue. We report 5 cases of coccidioidomycosis in which hyphae were found in brain tissue or spinal fluid. The presence of central nervous system plastic devices appears to be associated with morphological reversion to the saprophytic form. This reversion has implications for diagnosis and therapy and may increase the risk of obstruction of the device(s).
authors.affiliation: Department of Medicine, Mission Viejo Community Hospital, Mission Viejo, CA, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Hagman
authors.forename: E G
authors.initials: EG
authors.lastname: Madnick
authors.forename: A N
authors.initials: AN
authors.lastname: D'Agostino
authors.forename: P L
authors.initials: PL
authors.lastname: Williams
authors.forename: S
authors.initials: S
authors.lastname: Shatsky
authors.forename: L F
authors.initials: LF
authors.lastname: Mirels
authors.forename: R M
authors.initials: RM
authors.lastname: Tucker
authors.forename: M G
authors.initials: MG
authors.lastname: Rinaldi
authors.forename: D A
authors.initials: DA
authors.lastname: Stevens
authors.forename: R E
authors.initials: RE
authors.lastname: Bryant
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001921:Brain / Q000382:microbiology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003045:Coccidioides / Q000145:classification* / Q000302:isolation & purification; D003047:Coccidioidomycosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
chemical_list: D000935:Antifungal Agents