• coccidioidomycosis
• brain
• meningioma

A 38 year old woman, originally from the Pacific Islands with a history of residence in south western United States, presented with new onset severe headaches. Past medical history included disseminated coccidioidomycosis involving cervical lymph nodes two years earlier, which was incompletely treated with oral fluconazole because of non-compliance. Serum complement fixation coccidioides titres had risen from 1:8 to 1:32. MRI demonstrated multiple isointense, dural based lesions that uniformly enhanced upon contrast administration. These were located over the …