Coccidioidal spondylitis: MR findings in 15 patients.

Denouement

“…In a review of the magnetic resonance imaging findings of 15 patients with coccidioidal spondylitis, 14 had disk space or extensive extraosseous soft-tissue abnormalities, including subligamentous spread of phlegmon, and 13 had epidural disease. 9 However, a miliary pattern in the lungs, as was seen in our patient, appears to be relatively infrequent, occurring in only 1 of the 15 patients in this review. 9 The finding of mature spherules containing 2-5 μm endospores within a tissue specimen is pathognomonic for Coccidioides infection.…”

“…9 However, a miliary pattern in the lungs, as was seen in our patient, appears to be relatively infrequent, occurring in only 1 of the 15 patients in this review. 9 The finding of mature spherules containing 2-5 μm endospores within a tissue specimen is pathognomonic for Coccidioides infection. The mycelial form grows well on conventional fungal media, but the morphologic appearance is not specific for Coccidioides.…”

Radiological Reasoning: Miliary Disease, Vertebral Osteomyelitis, and Soft-Tissue Abscesses

“…[13]. As in our patient, vertebral coccidioidomycosis usually is manifested on conventional radiography and CT as osteomyelitis with extension into the soft tissues, creating paraspinal phlegmona and abscesses with the potential for sinus tract formation [14,15].…”

“…MR findings associated with coccidioidal spondylitis appeared in the literature in 1998 [13]. Despite the preservation of disk height on radiographs, disk space involvement is almost always present on MRI.…”

Osteomyelitis

“…Die Wirbelsäule, die Rippen und das Becken sind hauptsächlich betroffen (Bernreuter 1989;Cuellar et al 1993;Olson et al 1998). Auffällig sind usurartige Osteodestruktionen an Protuberanzen des Knochens, z.…”