Disseminated coccidioidomycosis of the spine

Coccidioidomycosis is a fungal infection caused by Coccidioides immitis and Coccidioides posadasii. While infections are usually mild, severe disease occurs in immunocompromised patients. Dissemination is associated with severe morbidity and mortality. Because of the tendency of this disease to imitate many diseases, diagnosis may be difficult on presentation. We present a case of disseminated coccidioidomycosis in a patient who was initially managed as miliary tuberculosis. In endemic areas, coccidioidomycosis is one of the two top differentials for miliary micronodular distribution on chest imaging. The patient was a recently diagnosed HIV positive patient and presented to the hospital with multiorgan failure, septic shock, and acute respiratory distress syndrome. He rapidly deteriorated and died within three days of presentation at the emergency department.

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“…Infections are usually self-limited. 60% of patients are asymptomatic or have mild respiratory illnesses [6,8,14].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Coccidioidomycosis Presenting as Septic Shock with Multiorgan Failure

Aduroja

Okudo

Padilla

2021

Case Reports in Infectious Diseases

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“…Coccidioidomycosis, also known as Valley Fever, was first described in the region of California's San Joaquin Valley [4]. The coccidioidomycosis spores form in warm wet soils that occur during monsoons or heavy rainfall.…”

Section: Discussionmentioning

confidence: 99%

“…Of those one percent with disseminated coccidioidomycosis, less than half will have vertebral involvement as the most common skeletal site [2]. African Americans, Filipino, Asian, Hispanic descent, impaired T-cell function, chronic steroids use, pregnancy, and antifungal noncompliance are at increased risk for disseminated coccidioidomycosis [4]. …”

Section: Discussionmentioning

confidence: 99%

Complications and Management of a Rare Case of Disseminated Coccidioidomycosis to the Vertebral Spine

Nakhla

2018

Case Reports in Infectious Diseases

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Coccidioidomycosis, also known as San Joaquin Valley Fever or Valley Fever, is mostly a pulmonary infection caused by inhalation of spores in an endemic region. Dissemination to bone, joints, meninges, and skin occurs less than one percent of the time. Skeletal involvement accounts for approximately half of the disseminated coccidioidomycosis with the vertebrae as the most common skeletal region. We present a very rare case of disseminated coccidioidomycosis with osteomyelitis and compression fracture of the lumbar vertebral body. This case depicts some of the potential issues that can arise in managing coccidioidomycosis, especially when noncompliance to initial azoles occurs, that can lead to dissemination and complicated bone infections necessitating surgical intervention along with continuous medical therapy.

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“…Skeletal sites of infection do not have a location bias, as any bone could be involved in dissemination, but the reported sites with the most severe disease manifestation have been in the axial skeleton, including the skull, sternum, ribs, and vertebrae [4,27,31,32], with the latter being slightly favored (especially the lumbar and thoracic areas), where C. immitis frequently disseminates [5,27,31]. Most clinical cases describe vertebral coccidioidomycosis as osteomyelitis (limited to the vertebral bodies) and discitis (intervertebral disc space involvement), with symptoms including vertebral body compression and height loss, worsening back and neck pain, lower extremities weakness, weight loss, night sweats [27,29,[33][34][35][36][37], epidural enhancement and abscess [27,29,35,37], paraspinal abscess [37] vertebral body complete destruction with focal kyphosis as well as retropharyngeal abscess [34].…”

Section: Clinical Reportsmentioning

confidence: 99%

Coccidioidomycosis Osteoarticular Dissemination

Moni¹,

Loots²,

Weilhammer³

2023

Preprint

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Valley fever or coccidioidomycosis is a pulmonary infection caused by several species of coccidi-oides (Cocci) fungi that is endemic to California and Arizona. Skeletal coccidioidomycosis ac-counts for about half of disseminated infections, with the vertebral spine being the preferred site of dissemination. Most cases of skeletal coccidioidomycosis progress to bone destruction or spread to adjacent structures such as joints, tendons, and other soft tissues causing significant pain and restricting mobility. Manifestations of such cases are usually non-specific, making di-agnosis very challenging, especially in non-endemic areas. In this review, we explore case reports of dissemination of coccidioidomycosis to bones and/or joints to highlight key differential fea-tures with other conditions or diseases and highlight opportunities for mechanistic and pre-clinical studies that can help improve diagnostics, prognostics, and treatments.

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Disseminated coccidioidomycosis of the spine

Cited by 8 publications

References 0 publications

Disseminated Coccidioidomycosis Presenting as Septic Shock with Multiorgan Failure

Disseminated Coccidioidomycosis Presenting as Septic Shock with Multiorgan Failure

Complications and Management of a Rare Case of Disseminated Coccidioidomycosis to the Vertebral Spine

Coccidioidomycosis Osteoarticular Dissemination

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