Abstract
Vertebral involvement is a severe complication of infection caused by Coccidioides species. We conducted a retrospective review of patients diagnosed with vertebral coccidioidomycosis at an academic medical center between 1996 and 2009. We identified 39 cases of vertebral coccidioidomycosis. Thirty-four patients (79%) were male, and 23 patients (61%) were black. Black patients were overrepresented in comparison with all other patients by a 50-fold odds ratio (95% confidence interval, 26-95). Only 8 patients (20%) were immunocompromised, including 7 who had received systemic steroids. The number of infected vertebrae ranged from 1 to 24; 8 patients (21%) had epidural involvement. All patients received a triazole as part of medical therapy, and 20 patients also received amphotericin B, typically early in the course. Twenty-six patients (67%) required surgery, 18 of whom also required hardware placement. The most common indication for surgery was pain, but 7 patients had neurologic compromise. No patients developed recurrent or refractory infection at the site of surgical debridement, but 6 patients experienced disease relapse after stopping antifungal therapy. Vertebral infection caused by Coccidioides species requires a multispe...Continue Reading
References
Sep 26, 1977·JAMA : the Journal of the American Medical Association·L J WesseliusE P Gall
Sep 1, 1983·Journal of Clinical Microbiology·M A WiedenD Pappagianis
Jul 1, 1980·Radiology·J P McGahanP E Palmer
Mar 1, 1995·The American Journal of Medicine·A CatanzaroG Cloud
Apr 20, 1995·The New England Journal of Medicine·D A Stevens
Jul 1, 1993·Annals of Internal Medicine·J N GalgianiJ R Graybill
May 1, 1996·Skeletal Radiology·M A ZeppaL S Steinbach
Sep 2, 1998·AJR. American Journal of Roentgenology·E M OlsonD Smilovitz
Nov 14, 2000·Annals of Internal Medicine·J N GalgianiM G Rinaldi
Jul 17, 2001·Journal of Neurosurgery·C J WrobelW Taylor
Jul 12, 2002·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Hitomi NakamuraAikichi Iwamoto
May 20, 2004·AJR. American Journal of Roentgenology·Na-Young JungJae-Young Byun
Sep 30, 2004·Spine·Yuri M LewickyStephen L Curtin
May 24, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Gregory M AnsteadJohn R Graybill
May 19, 2006·Emerging Infectious Diseases·Lisa ValdiviaJohn N Galgiani
Nov 2, 2006·Spine·Joseph S ButlerJohn M O'Byrne
Jul 11, 2007·Clinical Orthopaedics and Related Research·Anil K Jain
Aug 9, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Antonino CatanzaroJohn N Galgiani
Mar 8, 2008·AJR. American Journal of Roentgenology·Gregory E WildeJames F Lally
Jan 14, 2009·Antimicrobial Agents and Chemotherapy·Alison FreifeldL Joseph Wheat
Jul 29, 2009·The American Journal of Medicine·Rodney D AdamMihra S Taljanovic
Nov 26, 2009·Neurology·Kendra W Drake, Rodney D Adam
Citations
Feb 20, 2014·BMC Medical Imaging·Yi-Chen LiRobert Lor Randall
Dec 11, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Lee A TanVincent C Traynelis
Jan 8, 2016·Infectious Disease Clinics of North America·Nathan W Stockamp, George R Thompson
Jan 9, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Joshua Fierer
Jul 15, 2015·Surgical Neurology International·Nikolay L MartirosyanAli A Baaj
Jul 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John N GalgianiNicholas Theodore
Aug 26, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John N GalgianiNicholas Theodore
Oct 16, 2015·Revista Do Instituto De Medicina Tropical De São Paulo·Neil M Ampel
Feb 7, 2017·Clinical Nuclear Medicine·John Randolph DrydenEugene David Silverman
Apr 27, 2018·JAAPA : Official Journal of the American Academy of Physician Assistants·Brandon M Carius, Charles J Kambe
Mar 19, 2020·Journal of General Internal Medicine·McKinsey M PillsburyJennifer M Babik
Nov 8, 2018·Osong Public Health and Research Perspectives·Seung-Hak ChoYoung-Kwon Kim
Jul 10, 2019·Brain Sciences·Dinesh RamanathanEsther Kim
Jun 14, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Alfredo G PuingAruna K Subramanian
May 22, 2021·Infectious Disease Clinics of North America·Derek J Bays, George R Thompson
Apr 3, 2021·Ophthalmic Plastic and Reconstructive Surgery·Donovan S ReedMarie Somogyi