Coccidioidal meningitis presenting as memory loss.

PURPOSE: This case study is designed to help the nurse practitioner recognize atypical symptoms of coccidioidal meningitis, particularly in high-risk groups that require further diagnostic treatment.

DATA SOURCES: Selected research, clinical articles, and case studies.

CONCLUSIONS

Coccidioidal meningitis is a potentially lethal infection unless recognized and treated. Unlike other infectious meningitides that present with more acute meningeal symptoms, disseminated coccidioidomycosis can present insidiously. When it presents as cognitive dysfunction, it may be mistaken for early dementia and if undiagnosed can result in death. While it is an infectious disease that is endemic to a small number of southwestern states, these areas see a high volume of tourists who can unwittingly become infected. Knowledge of this infectious disease and the many ways it can imitate other diseases is critical to its early recognition and treatment.

IMPLICATIONS FOR PRACTICE: Failure to recognize this reemerging, endemic fungal infection in high-risk groups can result in death.