Spinal Coccidioidomycosis: A Current Review of Diagnosis and Management

Martinez-del-Campo, Eduardo; Kalb, Samuel; Rangel-Castilla, Leonardo; Moon, Karam; Moran, Ana; Gonzalez, Omar; Soriano-Baron, Hector; Theodore, Nicholas

doi:10.1016/j.wneu.2017.08.103

Cited by 25 publications

(27 citation statements)

References 34 publications

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“…The lack of a routine diagnostic laboratory testing specific for CDM makes the diagnosis very difficult 9 . Histological lesions of both tuberculosis (TB) and CDM can be granulomatous, leading to diagnostic errors 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Early identification of CDM has many benefits, such as relieving the patient's anxiety and ruling out the possibility of cancer, simultaneously. It also reduces the need for additional diagnostic testing by eliminating the empirical use of antibiotics and reducing morbidity due to extrapulmonary complications 10 , 11 . This infection can have serious consequences in immunocompromised individuals from endemic areas, including patients undergoing chemotherapy for malignancies, those infected by HIV, among others 10 .…”

Section: Discussionmentioning

confidence: 99%

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Coccidioidomycosis: first cases reported in Pernambuco, Brazil

Araújo

Souza

Oliveira

et al. 2018

Rev. Inst. Med. trop. S. Paulo

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Coccidioidomycosis is a fungal infection caused by Coccidioides immitis or Coccidioides posadasii. These fungi are known to thrive in desert climate. Fungi produce infectious arthroconidia in soil, they are aerosolized in the air and when inhaled by humans, usually cause infections such as pneumonia. The first cases of coccidioidomycosis in Brazil were reported in 1978. Since then, there have been other reports mainly from desert regions of Northeastern Brazil. The present report describes three cases of coccidioidomycosis on male farmers from Serra Talhada county, Pernambuco State, who developed pneumonia and were subsequently diagnosed with pulmonary coccidioidomycosis. These three farmers were successfully treated with oral fluconazole. They reported having hunted armadillos in a rural and arid area of Pernambuco State. Armadillos are known to be carriers of Coccidioides. This is the first report of infection caused by Coccidioides in Pernambuco State, Brazil.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coccidioidomycosis: first cases reported in Pernambuco, Brazil

Araújo

Souza

Oliveira

et al. 2018

Rev. Inst. Med. trop. S. Paulo

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“…75 However, involvement of the spinal cord itself is a rarer occurrence. 74,[76][77][78] In a case series of 23 patients with coccidioidal meningitis, seven had intramedullary T2 hyperintense signal abnormality on MRI consistent with myelitis. Of note, four of these developed while undergoing treatment for CNS infection.…”

Section: Fungal Myelitismentioning

confidence: 99%

Infectious Myelitis

et al. 2019

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Myelitis refers to inflammation of the spinal cord which can result in a spectrum of neurologic impairment. Infectious pathogens are an important etiologic category, and can result in myelitis through direct pathogenic effect or through immune-mediated parainfection; this review focuses on the former category. The spectrum of clinical manifestations is summarized and a diagnostic workup provided to aid clinicians in developing an approach to patients presenting with symptoms suggestive of infectious myelitis. This is followed by an overview of the important viral, bacterial, parasitic, and fungal causes of infectious myelitis. The typical presentations, diagnostic modalities, and treatment approaches are outlined for key pathogens culprit in infectious myelitis to allow clinicians to promptly recognize and diagnose specific infectious etiologies of myelitis.

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“…Myelopathy most commonly results from secondary spinal cord damage in the context of epidural abscess formation, granulomas of the meninges, and bony destruction of the spine. 156,157 Fungi to consider in the context of myelopathy include aspergillosis, cryptococcus, candida, blastomyces, and coccidioidomycosis species. 77 Spread of infection frequently leads to associated paraspinal abscesses.…”

Section: Myelopathymentioning

confidence: 99%

“…Here we highlight spinal involvement of exserohilum rostratum during the fungal CNS infection outbreak associated with contaminated steroid injections during 2012 to 2013. 156,157 Exserohilum Rostratum Infections During the 2012 to 2013 Fungal Meningitis Outbreak Seven hundred and fifty-one cases of CNS fungal infection, including 325 spinal and paraspinal infections, 151 meningitis, and spinal/paraspinal infections, were reported during the 2012 to 2013 U.S. fungal meningitis outbreak associated with steroid injections. 158 Many patients were found to have an insidious onset of spinal or paraspinal infection at the injection site, with symptoms delayed for weeks to months after exposure, often with subtle or absent clinical findings.…”

Section: Myelopathymentioning

confidence: 99%

Fungal Infections of the Central Nervous System

Jia

Thakur

2019

Semin Neurol

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Fungal central nervous system infections present in a myriad of clinical manifestation and remain a significant diagnostic challenge. Presenting symptoms, cerebrospinal fluid analysis, conventional fungal serum markers and imaging correlates of disease are seldom sensitive or specific; fungal culture growth or histopathologic analysis are often required for definitive diagnoses but limited by feasibility. Novel diagnostic tools (such as the cryptococcal antigen and next-generation sequencing) have increased diagnostic potency when available but require further studies to define their utility.Invasive fungal infections are an emerging health threat in the setting of increased immunomodulatory treatments, advancements in transplant medicine and increased world-wide travel. Therefore, strong clinical suspicion from epidemiologic clues, clinical progression and presence of CNS dissemination risk factors must be exercised to pursue broad diagnostic workups and rapidly initiate medical and surgical management. This article will describe the epidemiology, clinical presentations, diagnostic approach and therapeutic interventions for fungal infections in the central nervous system.

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Spinal Coccidioidomycosis: A Current Review of Diagnosis and Management

Cited by 25 publications

References 34 publications

Coccidioidomycosis: first cases reported in Pernambuco, Brazil

Coccidioidomycosis: first cases reported in Pernambuco, Brazil

Infectious Myelitis

Fungal Infections of the Central Nervous System

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