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Imaging spectrum of CNS coccidioidomycosis: prevalence and significance of concurrent brain and spinal disease.

OBJECTIVE: The purpose of this study was to evaluate the prevalence and significance of concurrent coccidioidal brain and intraspinal disease.

MATERIALS AND METHODS: We conducted a retrospective imaging review of 23 patients with proven coccidioidal CNS meningitis.

RESULTS: All patients had intracranial abnormalities, and 86% (19/22) who underwent spinal imaging had signs of intraspinal disease, including leptomeningeal enhancement (84%), arachnoiditis (63%), and cord signal abnormalities (37%); seven of 15 patients (47%) who underwent myelography had complete spinal blocks.

CONCLUSION: The high prevalence of concurrent brain and intraspinal coccidioidomycosis supports a low threshold for spinal imaging.

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