Disseminated Coccidioides posadasii Infection in Pregnancy Complicated by Central Nervous System Disease: A Case Report and Review.

Coccidioidomycosis is typically a self-limited pulmonary infection but may cause severe disseminated disease in pregnancy. Central nervous system involvement is the most serious manifestation and can be diagnostically challenging due to nonspecific symptoms. We report a case of disseminated Coccidioides posadasii infection in a pregnant patient presenting with persistent headache subsequently complicated with coccidioidal meningitis and hydrocephalus requiring neurosurgical intervention. This case highlights the importance of maintaining suspicion for endemic fungal infections in pregnant patients with unexplained neurologic symptoms and emphasizes the need for early, multidisciplinary management to prevent significant morbidity and mortality for both the mother and the fetus.