Adjunctive Corticosteroid Therapy in the Treatment of Coccidioidal Meningitis

George R Thompson 3rd; Janis E Blair; Sharon Wang; Robert Bercovitch; Michael Bolaris; Dane Van Den Akker; Rodrigo Lopez; Arash Heidari; Antonino Catanzaro; Jose Cadena; Peter Chin-Hong; Brad Spellberg; Royce Johnson

doi:10.1093/cid/cix318

Adjunctive Corticosteroid Therapy in the Treatment of Coccidioidal Meningitis

Clin Infect Dis. 2017 Jul 15;65(2):338-341. doi: 10.1093/cid/cix318.

Authors

George R Thompson 3rd^{1

2}, Janis E Blair³, Sharon Wang², Robert Bercovitch⁴, Michael Bolaris⁵, Dane Van Den Akker⁶, Rodrigo Lopez⁷, Arash Heidari⁸, Antonino Catanzaro⁴, Jose Cadena^{7

9}, Peter Chin-Hong¹⁰, Brad Spellberg¹¹, Royce Johnson⁸

Affiliations

¹ Department of Medical Microbiology and Immunology.
² Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center.
³ Mayo Clinic Arizona, Scottsdale.
⁴ Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of California, San Diego.
⁵ Department of Internal Medicine, University of California, Los Angeles (UCLA) Medical Center.
⁶ Department of Internal Medicine, Harbor-UCLA Medical Center,Torrance.
⁷ Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Sciences Center at San Antonio.
⁸ David Geffen School of Medicine, University of California, Los Angeles.
⁹ South Texas Veterans Health Care System, San Antonio.
¹⁰ Department of Internal Medicine, Division of Infectious Diseases, University of California, San Francisco.
¹¹ Los Angeles County + University of Southern California Medical Center.

Abstract

Coccidioidal meningitis (CM) has high morbidity, and adjunctive measures to improve outcomes are needed. Using an established multicenter retrospective cohort study of CM (N = 221), we found that patients receiving adjunctive corticosteroids had a significant reduction in secondary cerebrovascular events (P = .0049). Those with CM-associated cerebrovascular events (8%) may benefit from short-term corticosteroids.

Keywords: coccidioidomycosis; corticosteroids; meningitis; stroke; vasculitis.

Publication types

Multicenter Study

MeSH terms

Adolescent
Adrenal Cortex Hormones / adverse effects
Adrenal Cortex Hormones / therapeutic use*
Adult
Aged
Aged, 80 and over
Child
Coccidioidomycosis / drug therapy*
Cohort Studies
Female
Humans
Male
Meningitis, Fungal / drug therapy*
Middle Aged
Retrospective Studies
Vasculitis / complications
Vasculitis / drug therapy
Young Adult

Substances

Adrenal Cortex Hormones