{
  "abstract": "A 20-year-old male presented with persistent aseptic meningitis. Cerebrospinal fluid (CSF) showed neutrophil-dominant pleocytosis, high protein, low glucose, and an opening pressure >55 cmH2O. Fluid metagenomic next-generation sequencing detected Coccidioides immitis/posadasii and subsequent culture confirmed the diagnosis. The retrospective history revealed residence in Arizona approximately six months prior to hospitalization. Antifungal therapy was escalated, and the patient was transferred to a tertiary neurocritical care center for advanced neurocritical care. This case demonstrates that geographic bias can delay the recognition of coccidioidal meningitis outside endemic regions. Clinicians should therefore obtain a patient’s travel history even if the patients have only a remote travel history.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "Shunsuke Kondo"
    },
    {
      "name": "Neha Kumar"
    },
    {
      "name": "Natsumi Hamahata"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/42jr67nkwtsr2.bib",
  "cited_by": 0,
  "doi": "10.2169/internalmedicine.7538-26",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7538-26/_article",
  "id": "42jr67nkwtsr2",
  "issns": [
    "1349-7235",
    "0918-2918"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7538-26/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/general"
    ],
    [
      "openalex",
      "2713|Fungal Infections and Studies"
    ]
  ],
  "openalex": "W7214601855",
  "pdf_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7538-26/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/42jr67nkwtsr2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.2169/internalmedicine.7538-26",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7538-26/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Fungal Infections and Studies",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Aseptic Meningitis Unmasking Coccidioidomycosis of the Central Nervous System Outside an Endemic Region",
  "title_text": "Aseptic Meningitis Unmasking Coccidioidomycosis of the Central Nervous System Outside an Endemic Region",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/42jr67nkwtsr2",
  "venue": "Internal Medicine",
  "versions": []
}