title: Routine CSF analysis in coccidioidomycosis is not required.
abstract: Although routinely done, there has been no evaluation of the utility of performing routine cerebrospinal fluid (CSF) examination in patients with active coccidioidomycosis and high complement fixation (IgG) antibody titers or other risk factors for disseminated infection. In our review 100% of patients diagnosed with coccidioidal meningitis had at least one sign or symptom consistent with infection of the central nervous system, headache was present in 100% of those with meningitis, while no patients without signs/symptoms of CNS infection were found to have coccidioidal meningitis, irrespective of antibody titers or other risk factors. Thus routine lumbar puncture may be unnecessary for patients with coccidioidomycosis who lack suggestive clinical symptoms.
authors.affiliation: Coccidioidomycosis Serology Laboratory, Department of Medical Microbiology and Immunology, University of California Davis, Davis, California, United States of America. grthompson@ucdavis.edu
authors.forename: George
authors.initials: G
authors.lastname: Thompson
authors.forename: Sharon
authors.initials: S
authors.lastname: Wang
authors.forename: Robert
authors.initials: R
authors.lastname: Bercovitch
authors.forename: Michael
authors.initials: M
authors.lastname: Bolaris
authors.forename: Dane
authors.initials: D
authors.lastname: Van Den Akker
authors.forename: Sandra
authors.initials: S
authors.lastname: Taylor
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Lopez
authors.forename: Antonio
authors.initials: A
authors.lastname: Catanzaro
authors.forename: Jose
authors.initials: J
authors.lastname: Cadena
authors.forename: Peter
authors.initials: P
authors.lastname: Chin-Hong
authors.forename: Brad
authors.initials: B
authors.lastname: Spellberg
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003047:Coccidioidomycosis / Q000134:cerebrospinal fluid* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult