{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:31:10Z","timestamp":1759336270009},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\"><jats:title>Background:<\/jats:title><jats:p>Coccidioidal meningitis (CM) is a fungal infectious disease that rarely affects children. Even in endemic areas, coccidiomycosis rarely affects the pediatric population. However, 40% of affected children develop hydrocephalus. Here, we describe the clinical, serological, and neuroimaging findings in a series of Mexican children admitted to our neurosurgical service with hydrocephalus and subsequently diagnosed with CM.<\/jats:p><\/jats:sec><jats:sec id=\"st2\"><jats:title>Methods:<\/jats:title><jats:p>We report a prospective series of pediatric patients with hydrocephalus secondary to CM in an endemic area at the north of Mexico. Our report includes children with CM who were hospitalized from 2015 to 2019 in a regional hospital in Torre\u00f3n, Coahuila. Clinical evolution was monitored for 1 year after hospital discharge.<\/jats:p><\/jats:sec><jats:sec id=\"st3\"><jats:title>Results:<\/jats:title><jats:p>Our series include five children with CM (2\u201317-years-old, three female), who were hospitalized for hydrocephalus and developed intracranial hypertension. The most frequent neuroimaging findings were leptomeningeal enhancement (5\/5) and basal arachnoiditis (4\/5), followed by asymmetric hydrocephalus (3\/5), abnormalities in fourth ventricle morphology (3\/5), and cerebral vasculitis (2\/5). CM was diagnosed by positive serology or pathology studies. All children were initially managed with fluconazole and a shunt was placed for management of hydrocephalus. Four patients recovered without permanent neurological deficits and one subject developed persistent vegetative state. One year after hospital discharge, none of the subjects died.<\/jats:p><\/jats:sec><jats:sec id=\"st4\"><jats:title>Conclusion:<\/jats:title><jats:p>This series contributes to the limited number of pediatric CM cases reported in the literature, and describes neuroimaging findings in the pediatric population. The cases here presented show that the identification of<jats:italic>Coccidioides<\/jats:italic>as causal agent in pediatric meningitis is crucial for targeted treatment and can affect dramatically neurological prognosis. Furthermore, our report stresses that even in endemic areas pediatric coccidiomycosis represents a diagnostic challenge, which is further exacerbated by the limited availability of resources in these regions. Therefore, a positive immunoglobulin G by enzyme immunoassay is enough for diagnosis of CM in endemic areas without access to CF.<\/jats:p><\/jats:sec>","DOI":"10.25259\/sni_895_2020","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T06:18:27Z","timestamp":1616566707000},"page":"119","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hydrocephalus in Mexican children with Coccidioidal Meningitis: Clinical, serological, and neuroimaging findings"],"prefix":"10.25259","volume":"12","author":[{"given":"Mar\u00eda F.","family":"De la Cerda-Vargas","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. A.","family":"Sandoval-Bonilla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, M\u00e9xico City, M\u00e9xico,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"McCarty","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Stanford University, Stanford, California, United States,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Chico-Ponce","family":"De Le\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Children\u2019s Hospital of Mexico \u201cFederico G\u00f3mez\u201d, Mexico City,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 A.","family":"Candelas-Rangel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge D.","family":"Rodr\u00edguez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Navarro-Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melisa A.","family":"Mu\u00f1oz- Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Health Education and Research, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Meza-Mata","sequence":"additional","affiliation":[{"name":"Department of Anatomycal Pathology, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena M.","family":"Fern\u00e1ndez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Health Education, Hospital de Especialidades N\u00b0 71, Instituto Mexicano del Seguro Social, Torre\u00f3n Coahuila,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana G.","family":"S\u00e1mano-Avi\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Hospital de Pediatr\u00eda, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, M\u00e9xico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"10.25259\/SNI_895_2020\/ref-1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1086\/427215","article-title":"Neuroimaging as a guide to predict outcomes for patients with coccidioidal meningitis","volume":"40","author":"Arsura","year":"2005","journal-title":"Clin Infect Dis"},{"key":"10.25259\/SNI_895_2020\/ref-2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s11046-010-9371-9","article-title":"Meningeal coccidioidomycosis diagnosed by real-time polymerase chain reaction analysis of cerebrospinal fluid","volume":"171","author":"Binnicker","year":"2011","journal-title":"Mycopathologia"},{"key":"10.25259\/SNI_895_2020\/ref-3","first-page":"541","article-title":"Clinical and immunological characteristics in pediatric patients with coccidioidomycosis in Northeastern Mexico","volume":"149","author":"Chavez","year":"2013","journal-title":"Gac Med Mex"},{"key":"10.25259\/SNI_895_2020\/ref-4","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1128\/IAI.37.2.609-616.1982","article-title":"Specificity of immunoglobulin E in coccidioidomycosis and correlation with disease involvement","volume":"37","author":"Cox","year":"1982","journal-title":"Infect Immun"},{"key":"10.25259\/SNI_895_2020\/ref-5","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.3174\/ajnr.A5818","article-title":"Spinal coccidioidomycosis: MR imaging findings in 41 patients","volume":"39","author":"Crete","year":"2018","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_895_2020\/ref-6","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/01.md.0000126762.91040.fd","article-title":"Coccidioidomycosis: A descriptive survey of a reemerging disease. 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