Vertebral Coccidioidomycosis: Presentation and Multidisciplinary Management

Szeyko, Larissa A.; Taljanovic, Mihra S.; Dzioba, Robert B.; Rapiejko, Jennifer L.; Adam, Rodney D.

doi:10.1016/j.amjmed.2011.10.018

Cited by 41 publications

(63 citation statements)

References 31 publications

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“…In these cases, only a small number had documentation of prior pulmonary infection, but most had a history of living in endemic regions at the time of diagnosis. The haematogenous spread of the fungus from the primary focus of infection is thought to be the predominant route of abdominal seeding, however paravertebral abscesses can extend into the iliopsoas 10. While this is a possibility in our case, there was no evidence of paravertebral disease in any of the radiological findings.…”

Section: Discussionmentioning

confidence: 48%

Iliopsoas coccidioidomycotic abscess with associated intra-abdominal extension in an immunocompetent patient

et al. 2012

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Section: Discussionmentioning

confidence: 48%

Iliopsoas coccidioidomycotic abscess with associated intra-abdominal extension in an immunocompetent patient

et al. 2012

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“…The central nervous system is a common site of extrapulmonary infection which typically manifests as basilar meningitis. Most of the literature that does describe spinal disease is focused on osseus involvement [5]. In rare instances, spinal cord involvement can occur.…”

Section: Discussionmentioning

confidence: 99%

Disseminated coccidioidomycosis presenting with intramedullary spinal cord abscesses: Management challenges

Bajema

Dalesandro

Fredricks

et al. 2017

Medical Mycology Case Reports

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Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses. Response to treatment occurred with prolonged systemic liposomal amphotericin B and voriconazole. An extended course of steroids was needed to blunt inflammation.

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“…In some series it even accounts for 20% to 50% of disseminated cases [7]. The knee and the spine are the most commonly affected musculoskeletal sites [7-9,12]. Often, fungal arthritis follows a chronic indolent course of several months that may lead to delays in diagnosis and inappropriate treatments [1].…”

Section: Discussionmentioning

confidence: 99%

“…48 hours), although 5 days or longer is required to be negative [3,15]. Serologic testing plays an important role in the non-invasive diagnosis of patients with coccidioidomycosis [3,5,9,10]. The IgM antibodies appear in the acute stage, and can detect in up to 75% of primary cases.…”

Section: Discussionmentioning

confidence: 99%

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Coccidiomycosis infection of the patella mimicking a neoplasm – two case reports

Calvert

Hanrahan

et al. 2014

BMC Med Imaging

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BackgroundCoccidioidomycosis is an endemic fungal infection in the southwestern of United States. Most infections are asymptomatic or manifest with mild respiratory complaints. Rare cases may cause extrapulmonary or disseminated disease. We report two cases of knee involvement that presented as isolated lytic lesions of the patella mimicking neoplasms.Case PresentationThe first case, a 27 year-old immunocompetent male had progressive left anterior knee pain for four months. The second case was a 78 year-old male had left anterior knee pain for three months. Both of them had visited general physicians without conclusive diagnosis. A low attenuation lytic lesion in the patella was demonstrated on their image studies, and the initial radiologist’s interpretation was suggestive of a primary bony neoplasm. The patients were referred for orthopaedic oncology consultation. The first case had a past episode of pulmonary coccioidomycosis 2 years prior, while the second case had no previous coccioidal infection history but lived in an endemic area, the central valley of California. Surgical biopsy was performed in both cases due to diagnostic uncertainty. Final pathologic examination revealed large thick walled spherules filled with endospores establishing the final diagnosis of extrapulmonary coccidioidomycosis.ConclusionsThough history and laboratory findings are supportive, definitive diagnosis still depends on growth in culture or endospores identified on histology. We suggest that orthopaedic surgeons and radiologists keep in mind that chronic fungal infections can mimic osseous neoplasm by imaging.

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Vertebral Coccidioidomycosis: Presentation and Multidisciplinary Management

Cited by 41 publications

References 31 publications

Iliopsoas coccidioidomycotic abscess with associated intra-abdominal extension in an immunocompetent patient

Iliopsoas coccidioidomycotic abscess with associated intra-abdominal extension in an immunocompetent patient

Disseminated coccidioidomycosis presenting with intramedullary spinal cord abscesses: Management challenges

Coccidiomycosis infection of the patella mimicking a neoplasm – two case reports

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