[Coccidioidomycosis revealed by specific cutaneous lesions occurring after placement of a ventricular cardiac shunt for chronic meningitis].
BACKGROUND
Coccidioidomycosis is a deep mycosis rare in France.


METHODS
We report the case of a patient with disseminated coccidioidomycosis and meningitis after travel to California. It initially suggested tuberculosis. The ensuing hydrocephalus required a ventricular peritoneal shunt, replaced by a ventricular cardiac shunt after an obstruction occurred. Diagnosis was made 18 months later when the patient developed specific plantar ulcerations. Dramatic improvement was observed under fluconazole and maintained after prolonged follow-up.


CONCLUSIONS
Coccidioidomycosis should be considered in any patient who presents with meningitis suggestive of tuberculosis who has traveled to endemic zones. Cutaneous dissemination secondary to a ventricular cardiac shunt is rare.
Buot
Geneviève
G
Laboratoire de parasitologie-mycologie, AP-HP, CHU Saint-Antoine, F-75012 Paris, France. genevieve.buot@tnn.aphp.fr
Bachmeyer
Claude
C
Haettich-Pialoux
Barbara
B
Bélangé
Georges
G
Thiébaut
Jean-Baptiste
JB
Dupont
Bertrand
B
Binet
Olivier
O
D000368:Aged; D000714:Anastomosis, Surgical; D000818:Animals; D006348:Cardiac Surgical Procedures; D002552:Cerebral Ventricles / Q000601:surgery*; D002908:Chronic Disease; D003047:Coccidioidomycosis / Q000150:complications / Q000175:diagnosis*; D016523:Foot Ulcer / Q000382:microbiology*; D006801:Humans; D016921:Meningitis, Fungal / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery*