A Single-center Experience of Coccidioides Meningitis in Immunocompetent Patients: Case Series and Literature Review

Recently, the California Department of Public Health issued an advisory related to the substantial rise in Coccidioidomycosis in California, which has been attributed in part to climate change and rapid housing development. Most cases are self-limiting, but some may spread to the meninges, resulting in coccidioidal meningitis (CM). Many providers mistakenly presume that CM is limited to patients who are immunocompromised. In this case series and literature review, we present 12 cases of CM in immunocompetent individuals seen at a single tertiary academic center between 1 January 2019 and 31 December 2023. All 12 cases developed complications, with 10 requiring ventriculoperitoneal shunting, 6 having spinal cord involvement (5 with cervical spine involvement), 4 having strokes, and 3 dying from complications related to CM. It is important to recognize CM as it may be life-threatening if not promptly diagnosed.