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Robert C. Stadalnik, MD; Elliot Goldstein, MD; Paul D. Hoeprich, MD; John P. McGahan, MD

Arch Intern Med. 1981;141(1):75-78.

Abstract
• The diagnostic utility of pentetate indium trisodium In 111 CSF studies, technetium Tc 99m brain scans, and computerized tomographic (CT) scans was evaluated in eight patients in whom coccidioidal meningitis developed following a dust storm in the Central Valley of California. The ¹¹¹In flow studies and the CT scans demonstrated hydrocephalus in five patients with clinical findings suggesting this complication. Ventriculitis has not previously been diagnosed before death in patients with coccidioidal meningitis; however, it was demonstrated in two patients by the technetium Tc 99m brain scan. Basal meningitis, which is indicative of fungal infection, is also detectable on contrastenhanced CT scan. The finding that communicating hydrocephalus occurs early in meningitis and interferes with CSF flow into infected basilar regions has important therapeutic implications in that antifungal agents injected into the lumbar subarachnoid space may not reach these regions.

(Arch Intern Med 141:75-78, 1981)

Author Affiliations
From the Sections of Nuclear Medicine (Dr Stadalnik) and Diagnostic Radiology (Dr McGahan), Department of Radiology, and the Section of Infectious and Immunologic Diseases, Department of Internal Medicine (Drs Goldstein and Hoeprich), School of Medicine, University of California, Davis.

Footnotes
Accepted for publication Feb 19, 1980.

Reprint requests to Department of Nuclear Medicine, University of California, Davis, Medical Center, 2315 Stockton Blvd, Room G-200, Sacramento, CA 95817 (Dr Stadalnik).

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