Vertebral Blastomycosis with Paravertebral Abscess: Report of Eight Cases and Review of the Literature

Bone is the third most frequent site of disease in patients with blastomycosis, and the vertebrae are among the bones affected most often. We describe the clinical features and treatment of eight patients with vertebral blastomycosis and review the literature regarding this disease. All eight patien...

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Bibliographic Details
Published in:Clinical infectious diseases 1998-02, Vol.26 (2), p.413-418
Main Authors: Saccente, Michael, Abernathy, Robert S., Pappas, Peter G., Shah, Hemendra R., Bradsher, Robert W.
Format: Article
Language:English
Subjects:
Abscess - complications
Abscess - diagnostic imaging
Abscess - microbiology
Abscess - therapy
Abscesses
Adolescent
Adult
Azoles
Biological and medical sciences
Blastomycoses and paracoccidioidomycosis
Blastomycosis
Blastomycosis - complications
Blastomycosis - diagnostic imaging
Blastomycosis - microbiology
Blastomycosis - therapy
Bone diseases
Bones
Clinical Articles
Fatal Outcome
Female
Fever
Human mycoses
Humans
Infectious diseases
Lesions
Lumbar Vertebrae - diagnostic imaging
Lungs
Mass
Medical sciences
Mycoses
Radiography
Spinal diseases
Spinal Diseases - complications
Spinal Diseases - diagnostic imaging
Spinal Diseases - microbiology
Spinal Diseases - therapy
Spine - diagnostic imaging
Thoracic Vertebrae - diagnostic imaging
Tomography Scanners, X-Ray Computed
Tropical mycoses
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Description
Summary:Bone is the third most frequent site of disease in patients with blastomycosis, and the vertebrae are among the bones affected most often. We describe the clinical features and treatment of eight patients with vertebral blastomycosis and review the literature regarding this disease. All eight patients had destructive vertebral lesions evident on radiographs, and all had clinical or radiographic evidence of a contiguous abscess. The lower thoracic or lumbar regions were affected most often. Fever and skin lesions typical of blastomycosis were variably present. All but one patient had an abnormal chest radiograph. Treatment included long-term antifungal therapy and drainage of large fluid collections. Five of the eight patients were cured of their disease. Of the other 3 patients, 1 is still receiving therapy and is probably cured, 1 died of blastomycosis, and the status of 1 is unknown. In areas of endemicity, blastomycosis should be a diagnostic consideration for any patient with a destructive vertebral lesion.
ISSN:1058-4838
1537-6591
DOI:10.1086/clinids/26.2.413