ArticleJournal of fungi (Basel, Switzerland)2022
Fluconazole Failure in the Treatment of Coccidioidal Meningitis.
Article in Journal of fungi (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Use of Intrathecal Amphotericin for Coccidioidal Meningitis.Open forum infectious diseases · 2025Trial
- Rising burden of severe pediatric coccidioidomycosis: a 25-year single-center study.Journal of the Pediatric Infectious Diseases Society · 2026Observational
- Drug Interactions for Inhibition or Killing ofJournal of fungi (Basel, Switzerland) · 2026Article
- Killing ofMicrobiology (Reading, England) · 2026Article
- Insights into current coccidioidomycosis therapeutic pathways.Antimicrobial agents and chemotherapy · 2025Article
- A scalp to make you squirm: Cutaneous myiasis hiding a unique presentation of disseminated coccidioidomycosis.IDCases · 2025Article
- Article
- Challenges in the Long-term Management of Patients With Coccidioidal Meningitis: A Retrospective Analysis of Treatment and Outcomes.Open forum infectious diseases · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCoccidioidal meningitis (CM) is the most lethal form of disseminated coccidioidomycosis. Current guidelines recommend fluconazole as initial therapy but there has been a paucity of data regarding failure of fluconazole and optimal fluconazole dosage in the treatment of CM. We conducted this study to understand risk factors for fluconazole failure.
methodsWe conducted a single-center retrospective chart review of patients diagnosed with coccidioidal meningitis between 1 January 1988 and 15 May 2021. Relevant demographic and clinical variables were collected, along with outcomes including treatment failure and death at any point. Univariate tests were conducted using the chi-squared goodness of fit test and analysis of variance.
resultsAmong 71 patients who began treatment for CM with fluconazole, 22 (31%) developed worsening meningitis at a median time of 206 days. Longer time from symptom onset to diagnosis of CM was a risk factor for fluconazole failure. Although the absolute failure rate of fluconazole starting dose of 400 mg daily was higher than that of 800 mg daily, the differences did not achieve statistical significance (
conclusionFluconazole failure is not uncommon in the treatment of CM. A dose of 800 mg daily was not superior to a dose of 400 mg daily. All patients on fluconazole for CM require close monitoring.
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