[Coccidioidomycosis revealed by specific cutaneous lesions occurring after placement of a ventricular cardiac shunt for chronic meningitis].

INTRODUCTION: Coccidioidomycosis is a deep mycosis rare in France.

CASE: 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.

COMMENTS: 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.