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Peyton Delaney, MD; Bob Niemann, MD

Arch Neurol. 1982;39(4):255-256.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Meningitis is the most common form of CNS involvement with Coccidioides immitis, occurring exclusively in those patients with disseminated disease.¹ A rare form is spinal cord compression from vertebral or epidural coccidioidal granuloma.^2-8 We describe a patient with disseminated coccidioidomycosis that mimicked a lymphoma with bony metastases and thoracic myelopathy.

REPORT OF A CASE

A 23-year-old man was referred to us because of respiratory distress and leg weakness. For five months he had complained of progressive leg weakness associated with unrelenting midthoracic back pain, anorexia, and weight loss. The patient was febrile and in marked respiratory distress. A large right supraclavicular lymph node was felt, and rales were heard throughout both lung fields. Neurologic examination revealed a mild encephalopathy and moderate spastic paraparesis with extensor plantar responses. A chest roentgenogram documented diffuse reticulonodular infiltrates and a right paratracheal mass. Multiple lytic lesions were seen in the pelvic bones . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Neurology, University of Texas Medical Branch, Galveston. Dr Delaney is now at the Audie L. Murphy Veterans Administration Hospital, San Antonio, Tex.

Footnotes
Accepted for publication May 20, 1981.

Reprint requests to Neurology 111-D, Audie L. Murphy Veterans Administration Hospital, 7400 Merton Minter Blvd, San Antonio, TX 78284 (Dr Delaney).

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