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Review
. 2013 May 22;8(5):e64249.
doi: 10.1371/journal.pone.0064249. Print 2013.

Routine CSF analysis in coccidioidomycosis is not required

George Thompson 3rd  1 , Sharon Wang, Robert Bercovitch, Michael Bolaris, Dane Van Den Akker, Sandra Taylor, Rodrigo Lopez, Antonio Catanzaro, Jose Cadena, Peter Chin-Hong, Brad Spellberg
Affiliations
Review

Routine CSF analysis in coccidioidomycosis is not required

George Thompson 3rd et al. PLoS One. .

Abstract

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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Conflict of interest statement

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.

Figures

Figure 1
Figure 1. Coccidioidal CF (IgG) serum antibody titers and association with coccidioidal meningitis.
See this image and copyright information in PMC

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