AJDRAJNR - American Journal of Neuroradiology

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ARTICLE

Disseminated Coccidioidomycosis Complicated by Vasculitis: A Cause of Fatal Subarachnoid Hemorrhage in Two Cases

William K. Erly,a, Enrique Labadiea, Paul L. Williamsa, Darlene M. Leea, Raymond F. Carmodya and Joachim F. Seegera

a From the Departments of Radiology (W.K.E., R.F.C., J.F.S.) and Pathology (D.M.L.), The University of Arizona, Tucson, AZ; the Veterans Affairs Medical Center (E.L.), Tucson, AZ; and the Visalia Medical Clinic (P.L.W.), Visalia, CA.

Summary: We describe two cases of disseminated coccidioidomycosis that were complicated by fatal subarachnoid hemorrhage. In the first case, a left middle cerebral artery aneurysm and long-segment vasculitis occurred. In the second case, MR imaging revealed an enlarging coccidioidal granuloma at the tip of the basilar artery, and the artery subsequently ruptured. Fatal intracranial hemorrhage is a rare complication of disseminated coccidioidomycosis.