Disseminated coccidioidomycosis in an immunocompetent traveler

Abstract

A 24-year-old woman presented to the emergency department with left-sided sensory and motor deficits, accompanied by dysarthria, following a recent hospitalization for aseptic meningitis. Prior to the first hospitalization, she had traveled to Mexico. Brain computed tomography (CT) and CT angiography revealed no acute intracranial abnormalities; however, multiple excavated nodular lesions were observed in both lungs. Serological and cerebrospinal fluid analyses confirmed the likely diagnosis of disseminated coccidioidomycosis. This report illustrates a case of coccidioidal meningitis with no notable primary infection in an immunocompetent patient after travelling. It demonstrates the emergence of imported diseases and the importance of travel history.