Routine CSF analysis in coccidioidomycosis is not required

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 patie...

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Published inPloS one Vol. 8; no. 5; p. e64249
Main Authors Thompson, 3rd, George, Wang, Sharon, Bercovitch, Robert, Bolaris, Michael, Van Den Akker, Dane, Taylor, Sandra, Lopez, Rodrigo, Catanzaro, Antonio, Cadena, Jose, Chin-Hong, Peter, Spellberg, Brad
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 22.05.2013
Public Library of Science (PLoS)
Subjects
Adult
Aged
Antibodies
Biomedical research
Case-Control Studies
Central nervous system
Cerebrospinal fluid
Coccidioides
Coccidioidomycosis
Coccidioidomycosis - cerebrospinal fluid
Coccidioidomycosis - physiopathology
Complement fixation
Critical care
Disseminated infection
Female
Headache
Health aspects
Health risks
Health sciences
Humans
Immunoglobulin G
Infections
Infectious diseases
Internal medicine
Lumbar puncture
Male
Medicine
Meningitis
Middle Aged
Patients
Risk analysis
Risk factors
Studies
Young Adult
Sacramento California
Los Angeles California
San Francisco California
California
United States > US
Texas
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Summary: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.
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Competing Interests: Funding for this study was generously provided by Pfizer. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.
Conceived and designed the experiments: GT SW AC JC PCH BS. Performed the experiments: SW RB MB DVDA RL. Analyzed the data: GT SW ST AC JC PCH BS. Wrote the paper: GT SW ST AC JC PCH BS.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0064249