March 2018 Case of the Month

Authors: Melony Chakrabarty MD and Archana Maniar MD UC-Davis Medical Center A 70yr old Hispanic male with presents with history of disseminated coccidioidomycosis diagnosed in 2004 with progression of disease in 2016 with basilar meningitis requiring ventriculoperitoneal shunt. He has been on Voriconazole 200mg BID since June 2016, and has had therapeutic Voriconazole levels since 8/2016 (ranging 2.6 – 5.1). Admitted February 2018 for acute on chronic weakness occurring after a fall 2-3 months ago where he lost coordination and tripped over a table. Noted joint pain over L shoulder, L elbow and 2nd and 3rd L metacarpals. He describes […]