1
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Gassie K, Rea B, Zamore R, Alikhani P. Rare case of syringohydromyelia expansion after kyphotic cervical deformity correction in a patient with history of spinal coccidiomeningitis. Neuroradiol J 2024; 37:361-365. [PMID: 37540579 PMCID: PMC11138335 DOI: 10.1177/19714009231193160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
Syringomyelia resulting from arachnoiditis due to disseminated coccidioidomycosis meningitis has been previously established in the literature. Worsening syringomyelia after kyphotic cervical deformity correction in a patient with spinal coccidioidomycosis, however, has not yet been reported. Herein we present an extremely rare case of disseminated coccidioidomycosis with cystic cervical lesions and an associated syrinx which, after undergoing cervical kyphotic deformity correction in the setting of iatrogenic loss of cervical lordosis, experienced acute syrinx expansion requiring urgent syringosubarachnoid shunt. To our understanding, this is the first case reported of such an event.
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Affiliation(s)
- Kelly Gassie
- Department of Neurological Surgery, Tampa General Hospital, University of South Florida, Tampa, FL, USA
| | - Brittany Rea
- Department of Radiology, Tampa General Hospital, University of South Florida, Tampa, FL, USA
| | - Robert Zamore
- Department of Radiology, Tampa General Hospital, University of South Florida, Tampa, FL, USA
| | - Puya Alikhani
- Department of Neurological Surgery, Tampa General Hospital, University of South Florida, Tampa, FL, USA
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2
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Tsantes AG, Koutserimpas C, Naoum S, Drosopoulou LP, Papadogeorgou E, Petrakis V, Alpantaki K, Samonis G, Veizi E, Papadopoulos DV. Diagnosis, Treatment, and Outcome of Coccidioidal Osseous Infections: A Systematic Review. J Fungi (Basel) 2024; 10:270. [PMID: 38667941 PMCID: PMC11050809 DOI: 10.3390/jof10040270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/31/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Extrapulmonary infections by Coccidioides spp., though rare, can occur via dissemination, affecting singular or multiple sites, including the skin and musculoskeletal system. Skeletal involvement often manifests as osteomyelitis, particularly in the axial skeleton. The present systematic review evaluates all documented cases of skeletal coccidioidomycosis to assess the diagnostic and treatment strategies alongside the outcomes, drawing insights from an analysis of 163 verified cases. A systematic review following PRISMA guidelines identified all studies reporting skeletal infections by Coccidioides spp. up to 2023 from the PubMed and Scopus databases. Eligible studies evaluated osteoarticular infections from Coccidioides spp. Data extraction included demographics, microbiological data, diagnostic methods, and treatment outcomes. Of the 501 initially identified records, a total of 163 patients from 69 studies met the inclusion criteria. Most cases were from the USA, predominantly males, while the median age of the population was 36 years. Diabetes mellitus was the common comorbidity (14.7%). C. immitis was the most prevalent pathogen. The spine and hand were common sites of infection (17.5% and 15.1%, respectively). Osteomyelitis by Coccidioides spp. was diagnosed, in most cases, by positive cultures (n = 68; 41.7%), while, in 49 (30.9%), both the histological examination and cultures yielded the fungus. Surgical debridement was performed in 80.9% of cases. A total of 118 (72.3%) patients were treated with monotherapy, while combination therapy with two or more antifungal agents was reported in 45 (17.7%). Amphotericin B (either liposomal or deoxycholate) was the most commonly given agent as monotherapy in 51 (31.2%) patients, while 30 (18.4%) patients received itraconazole as monotherapy. The rate of infection's resolution was higher in patients undergoing surgical debridement (79.5%), compared to those treated only with antifungal agents (51.6%, p = 0.003). Treatment outcomes showed complete resolution in 74.2% of patients, with a mortality rate of 9.2%. Coccidioidal osseous infections present diagnostic and therapeutic challenges. Surgical intervention is often necessary, complementing antifungal therapy. Vigilance for Coccidioides spp. infections, especially in regions with endemicity, is crucial, particularly when bacterial cultures yield negative results.
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Affiliation(s)
- Andreas G. Tsantes
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Microbiology Department, “Saint Savvas” Oncology Hospital, 11522 Athens, Greece;
| | - Christos Koutserimpas
- Orthopaedic Surgery and Sports Medicine Department, Croix-Rousse Hospital, University Hospital, 69317 Lyon, France;
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527 Athens, Greece
| | - Symeon Naoum
- Department of Trauma and Orthopedics, Royal Berkshire Hospital, Reading RG1 5AN, UK;
| | | | - Ellada Papadogeorgou
- Department of Orthopedics, Interbalkan Medical Center, 55535 Thessaloniki, Greece;
| | - Vasileios Petrakis
- 2nd University Department of Internal Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68131 Alexandroupolis, Greece;
- Department of Infectious Diseases, HIV Unit, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68131 Alexandroupolis, Greece
| | - Kalliopi Alpantaki
- Department of Orthopaedics and Traumatology, “Venizeleion” General Hospital of Heraklion, 71409 Iraklio, Greece;
| | - George Samonis
- First Department of Medical Oncology, Metropolitan Hospital of Neon Faliron, 18547 Athens, Greece;
- School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Yıldırım Beyazıt University, Ankara City Hospital, 2367 Ankara, Turkey
| | - Dimitrios V. Papadopoulos
- 2nd Academic Department of Orthopaedics, School of Medicine, National & Kapodistrian University of Athens, 14233 Athens, Greece;
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Charles-Lozoya S, Ruíz-Zenteno G, Lizcano-Martínez ME, Cobos-Aguilar H, León-Ruíz J, Domínguez-Delgado J. Vertebral coccidioidomycosis with mechanical instability treated solely with antifungals: A case report. Med Mycol Case Rep 2023; 42:100615. [PMID: 38022891 PMCID: PMC10656722 DOI: 10.1016/j.mmcr.2023.100615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Surgical treatment of vertebral coccidioidomycosis presents a challenge, with an unpredictable course and uncertain results. We present a 52-year-old man with disseminated infection due to coccidioidomycosis in the thoracolumbar spine, with vertebral instability, and deferral surgical treatment due to SARS-CoV-2 contingency. Treatment with itraconazole was initiated, followed by liposomal amphotericin B and fluconazole due to a relapse. The patient was discharged long-term with voriconazole. The axial pain improved without neurological deficits. Surgical treatment was not required. 2012 Elsevier Ltd. All rights reserved.
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Affiliation(s)
- Sergio Charles-Lozoya
- Health Science Division, Unit of Spine Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Av. José Ma. Pino Suárez y Juan Ignacio Ramón s/n, Centro, 64300, Monterrey, NL., Mexico
- Health Science Division, Vice-rectory of Health Sciences, Universidad de Monterrey, Av. Ignacio Morones Prieto 4500 Pte.col. Jesus M. Garza, 66238, San Pedro Garza García, N.L., Mexico
| | - Gibran Ruíz-Zenteno
- Health Science Division, Unit of Spine Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Av. José Ma. Pino Suárez y Juan Ignacio Ramón s/n, Centro, 64300, Monterrey, NL., Mexico
| | - María E. Lizcano-Martínez
- Health Science Division, Unit of Spine Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Av. José Ma. Pino Suárez y Juan Ignacio Ramón s/n, Centro, 64300, Monterrey, NL., Mexico
| | - Héctor Cobos-Aguilar
- Health Science Division, Vice-rectory of Health Sciences, Universidad de Monterrey, Av. Ignacio Morones Prieto 4500 Pte.col. Jesus M. Garza, 66238, San Pedro Garza García, N.L., Mexico
| | - Joél León-Ruíz
- Health Science Division, Unit of Spine Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Av. José Ma. Pino Suárez y Juan Ignacio Ramón s/n, Centro, 64300, Monterrey, NL., Mexico
| | - Jesús Domínguez-Delgado
- Health Science Division, Unit of Spine Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Av. José Ma. Pino Suárez y Juan Ignacio Ramón s/n, Centro, 64300, Monterrey, NL., Mexico
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Moni BM, Wise BL, Loots GG, Weilhammer DR. Coccidioidomycosis Osteoarticular Dissemination. J Fungi (Basel) 2023; 9:1002. [PMID: 37888258 PMCID: PMC10607509 DOI: 10.3390/jof9101002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
Valley fever or coccidioidomycosis is a pulmonary infection caused by species of Coccidioides fungi that are endemic to California and Arizona. Skeletal coccidioidomycosis accounts 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 nonspecific, making diagnosis very challenging, especially in non-endemic areas. The lack of basic knowledge and research data on the mechanisms defining susceptibility to extrapulmonary infection, especially when it involves bones and joints, prompted us to survey available clinical and animal data to establish specific research questions that remain to be investigated. In this review, we explore published literature reviews, case reports, and case series on the dissemination of coccidioidomycosis to bones and/or joints. We highlight key differential features with other conditions and opportunities for mechanistic and basic research studies that can help develop novel diagnostic, prognostic, and treatment strategies.
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Affiliation(s)
- Benedicte M. Moni
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Barton L. Wise
- Lawrence J. Ellison Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of California Davis Health, 2700 Stockton Blvd., Sacramento, CA 95817, USA; (B.L.W.)
| | - Gabriela G. Loots
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
- Lawrence J. Ellison Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of California Davis Health, 2700 Stockton Blvd., Sacramento, CA 95817, USA; (B.L.W.)
| | - Dina R. Weilhammer
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
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Koutserimpas C, Naoum S, Melissinos EP, Raptis K, Alpantaki K, Dretakis K, Piagkou M, Samonis G. Spinal Infections Caused by Coccidioides Species. MAEDICA 2023; 18:209-215. [PMID: 37588822 PMCID: PMC10427092 DOI: 10.26574/maedica.2023.18.2.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Introduction: Spinal Coccidioidomycosis, although rare, represents the most frequent osseous presentation of Coccidioides spp infection. The present review aims to describe the anatomical distribution, the epidemiological characteristics, and the diagnostic and therapeutic approach of this severe infection. Methods:A meticulous review of all published spinal Coccidioidomycosis cases was carried out. The studied population's demographics and the anatomical distribution of the infection were recorded. Furthermore, the medical and operative management as well as the disease outcome were studied. Results:Seventy-six cases (of which 78.9% males) with a mean age of 35.5 years were located. Regarding the anatomical distribution of the infection, the thoracic area was the most commonly affected spine region (26.3%). Among the studied patients, 14 (18.4%) were immunocompromised. Pain was the most commonly reported symptom (21.1%). Regarding the diagnostic approach of this infection, plain x-ray or CT scan indicated the disease in the majority of cases (44.7%). Pathology (48.7%), serology (42.1%) and microbiological examinations (35.5%) further established the firm diagnosis, with Coccidioides immitis being the most frequently isolated fungus. Medical management included mainly amphotericin B (in 57.9% of cases), followed by fluconazole (in 38.2% of cases). The disease required surgical intervention in the majority of cases (76.3%), while the infection had a successful outcome in 80.3% of cases. Conclusion:Spinal Coccidioidomycosis seems to require prolonged medical treatment, including proper antifungal therapy and, in most cases, operative management. Multidisciplinary approach, including infectious disease specialists, orthopaedic and/or spine surgeons, microbiologists and radiologists seems to be of utmost important for yielding favorable outcomes.
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Affiliation(s)
- Christos Koutserimpas
- Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece
| | - Symeon Naoum
- Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece
| | - Ektor P Melissinos
- School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Raptis
- Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece
| | - Kalliopi Alpantaki
- Department of Orthopaedics and Traumatology, "Venizeleion" General Hospital of Crete, 71409 Heraklion, Greece
| | - Konstantinos Dretakis
- 2nd Department of Orthopaedics, "Hygeia" General Hospital of Athens, 151-23 Marousi, Greece
| | - Maria Piagkou
- Department of Anatomy, School of Health Sciences, Department of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - George Samonis
- Department of Medicine, University of Crete, 71500 Heraklion, Greece
- First Department of Medical Oncology, "Metropolitan" Hospital, Neon Faliron, 185-47 Attica, Greece
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Koutserimpas C, Naoum S, Raptis K, Vrioni G, Samonis G, Alpantaki K. Skeletal Infections Caused by Coccidioides Species. Diagnostics (Basel) 2022; 12:diagnostics12030714. [PMID: 35328269 PMCID: PMC8947487 DOI: 10.3390/diagnostics12030714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/12/2022] [Accepted: 03/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Coccidioidomycosis represents an endemic and challenging disease, with rare extrapulmonary manifestations. The present review of all published cases of core and extremities osseous coccidioidomycosis aims to describe epidemiology, patients’ characteristics, symptoms as well as medical and surgical treatment options and their effectiveness. Methods: A thorough review of all published skeletal core and extremity infections due to Coccidioides species was conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical management as well as the infection outcome was recorded. Results: A total of 92 cases of Coccidioides spp. skeletal infections were recorded in 87 patients. The patients’ mean age was 35.3 years. The most common site of infection was the spine (82.6%), followed by the foot (6.5%), while the predominant symptom upon presentation was pain (29.9%). Immunosuppressive conditions and/or medications were observed in 21 patients (24.1%). Regarding imaging methods, indicating diagnosis, plain X-rays or CT scans were performed in most patients (50.6%), followed by magnetic resonance imaging (MRI) (47.1%). Most cases were diagnosed through histopathology (62; 71.3%), followed by serology testing (36; 42.4%) and by cultures (35; 40.2%). In 32 cases (36.8%), Coccidioides immitis was cultured, while in the remaining 55 cases (63.2%) the fungus was not further characterized. Regarding AFT, amphotericin B was the preferred agent (52.9%), followed by fluconazole (43.3%). In most cases (78.2%) surgical treatment was also performed. Treatment was successful in 80.5% of cases. Conclusions: Skeletal core and extremity infections due to Coccidioides spp. represent a severe disease. With the available data, the combination of prolonged proper AFT with surgical intervention seems to be the optimal current therapeutic approach.
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Affiliation(s)
- Christos Koutserimpas
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (C.K.); (S.N.); (K.R.)
| | - Symeon Naoum
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (C.K.); (S.N.); (K.R.)
| | - Konstantinos Raptis
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (C.K.); (S.N.); (K.R.)
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - George Samonis
- Department of Internal Medicine, University of Crete, 71500 Heraklion, Greece
- Correspondence: ; Tel.: +30-6948712130
| | - Kalliopi Alpantaki
- Department of Orthopaedics and Traumatology, “Venizeleion” General Hospital of Crete, 71409 Heraklion, Greece;
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Azeem A, Quimby D, Krajicek B, Horne J. (Ig)Easy diagnosis of disseminated coccidioidomycosis. BMJ Case Rep 2022; 15:e248894. [PMID: 35260409 PMCID: PMC8905869 DOI: 10.1136/bcr-2022-248894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 11/03/2022] Open
Abstract
An immunocompetent man in his 20s came to the hospital for shortness of breath, fevers and lower back pain with unintentional 20 lbs. weight loss. Relevant history included a recent trip to Arizona 3 months prior to presentation. On arrival, he was noted to have decreased breath sounds bilaterally, and paraspinal tenderness in the lumbar area. CT scan revealed diffuse pneumonitis and an abscess with osteomyelitis in the sacrum and right iliac bone. Continued respiratory decompensation led him to the intensive care unit where he had a bronchoscopy and later sacroiliac joint fluid collection was performed. Based on his travel history, and elevated serum IgE, liposomal amphotericin B was initiated. Later his antibodies against Coccidiodes resulted elevated and fungal cultures from the bronchoalveolar lavage and abscess from the sacral vertebrae grew mould, morphologically consistent with Coccidiodes posadasii He was transitioned to oral fluconazole and will have a close follow-up outpatient.
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Affiliation(s)
- Ahad Azeem
- Infectious Diseases, Creighton University, Omaha, Nebraska, USA
| | - David Quimby
- Infectious Diseases, Creighton University, Omaha, Nebraska, USA
| | - Bryan Krajicek
- Pulmonary, Critical Care and Sleep Medicine Department, Creighton University, Omaha, Nebraska, USA
| | - John Horne
- Infectious Diseases, Creighton University, Omaha, Nebraska, USA
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Pojskić M, Carl B, Schmöckel V, Völlger B, Nimsky C, Saβ B. Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis. Brain Sci 2021; 11:brainsci11081019. [PMID: 34439638 PMCID: PMC8394582 DOI: 10.3390/brainsci11081019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 12/19/2022] Open
Abstract
Surgical treatment of spondylodiscitis allows for rapid mobilization and shortens hospital stays, which makes surgical treatment the first-line therapy. We aim to describe our experiences with operative treatment on spondylodiscitis and to determine the parameters that are important in the prediction of outcomes. A retrospective review identified 237 patients who were operatively treated for spondylodiscitis in our institution between January 2010 and December 2018. Clinical data were collected through review of electronic records and relevant imaging. In all cases, contrast-enhancing MRI from the infected region of the spine was obtained. Leukocyte count and C-reactive protein concentrations (CRP) were determined in all the patients. We included 237 patients in the study, 87 female (36.7%) and 150 male (63.3%), with a mean age of 71.4 years. Mean follow-up was 31.6 months. Forty-five patients had spondylodiscitis of the cervical, 73 of the thoracic, and 119 of the lumbosacral spine. All the patients with spondylodiscitis of the cervical spine received instrumentation. In thoracic and lumbar spine decompression, surgery without instrumentation was performed in 26 patients as immediate surgery and in a further 28 patients in the early stages following admission, while 138 patients received instrumentation. Eighty-nine patients (37.6%) had concomitant infections. Infection healing occurred in 89% of patients. Favorable outcomes were noted in patients without concomitant infections, with a normalized CRP value and in patients who received antibiotic therapy for more than six weeks (p < 0.05). Unfavorable outcomes were noted in patients with high CRP, postoperative spondylodiscitis, and recurrent spondylodiscitis (p < 0.05). Application of antibiotic therapy for more than six weeks and normalized CRP showed a correlation with favorable outcomes, whereas concomitant infections showed a correlation with unfavorable outcomes. A detailed screening for concomitant infectious diseases is recommended.
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Affiliation(s)
- Mirza Pojskić
- Department of Neurosurgery, University of Marburg, 65199 Marburg, Germany; (B.C.); (V.S.); (B.V.); (C.N.); (B.S.)
- Correspondence: ; Tel.: +49-64215869848
| | - Barbara Carl
- Department of Neurosurgery, University of Marburg, 65199 Marburg, Germany; (B.C.); (V.S.); (B.V.); (C.N.); (B.S.)
- Marburg Center for Mind, Brain and Behavior (MCMBB), 65199 Marburg, Germany
- Department of Neurosurgery, Helios Dr. Horst Schmidt Kliniken, 65199 Wiesbaden, Germany
| | - Vincent Schmöckel
- Department of Neurosurgery, University of Marburg, 65199 Marburg, Germany; (B.C.); (V.S.); (B.V.); (C.N.); (B.S.)
| | - Benjamin Völlger
- Department of Neurosurgery, University of Marburg, 65199 Marburg, Germany; (B.C.); (V.S.); (B.V.); (C.N.); (B.S.)
| | - Christopher Nimsky
- Department of Neurosurgery, University of Marburg, 65199 Marburg, Germany; (B.C.); (V.S.); (B.V.); (C.N.); (B.S.)
- Marburg Center for Mind, Brain and Behavior (MCMBB), 65199 Marburg, Germany
| | - Benjamin Saβ
- Department of Neurosurgery, University of Marburg, 65199 Marburg, Germany; (B.C.); (V.S.); (B.V.); (C.N.); (B.S.)
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Disseminated coccidioidomycosis in an immunocompetent patient: Report of a case and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2021.200521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Sakya SM, Sakya JP, Hallan DR, Warraich I. Spinal Coccidioidomycosis: A Complication From Medication Noncompliance. Cureus 2020; 12:e9304. [PMID: 32832301 PMCID: PMC7437094 DOI: 10.7759/cureus.9304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Spinal coccidioidomycosis is a rare disseminated form of coccidioidomycosis infection. According to the literature, majority of patients are African American males. We present a rare case of spinal coccidioidomycosis in a young, Caucasian female with coccidioidomycosis meningitis at age 16 years who presented with bilateral lower extremity weakness after antifungal medication lapse for one year. Imaging revealed cystic arachnoid formations along her thoracic spine. Pathology report confirmed spinal arachnoiditis with coccidioidomycosis. This case report details a rare incidence of spinal coccidioidomycosis and reviews previous literature.
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Affiliation(s)
- Surav M Sakya
- Medicine, Penn State College of Medicine, Hershey, USA
| | - Judy P Sakya
- Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - David R Hallan
- Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Irfan Warraich
- Pathology, Texas Tech University Health Sciences Center, Lubbock, USA
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11
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Puing AG, Couture-Cossette A, Wang AX, Zygourakis CC, Cheng X, Stevens BA, Banaei N, Novoa RA, Ho DY, Subramanian AK. Simultaneous coccidioidomycosis and phaeohyphomycosis in a kidney transplant recipient: A case report and literature review. Transpl Infect Dis 2020; 22:e13365. [PMID: 32533741 DOI: 10.1111/tid.13365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
Advances in solid organ transplantation have improved the survival of end-stage organ disease at the expense of an increased risk for opportunistic infections. Unusual clinical presentations and the possibility of concurrent infections make diagnosing invasive fungal infection (IFI) more difficult. Here, we present a case of simultaneous vertebral infection caused by Coccidioides immitis-posadasii and subcutaneous phaeohyphomycosis due to Nigrograna mackinnonii in a kidney transplant recipient. The diagnosis of both infections required invasive procedures to obtain tissue and a high index of suspicion that more than one IFI could be present. A multidisciplinary team approach for the management of immunocompromised patients with suspected or diagnosed IFI is warranted.
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Affiliation(s)
- Alfredo G Puing
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Antoine Couture-Cossette
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Aileen X Wang
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Corinna C Zygourakis
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Xingxing Cheng
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Bryan A Stevens
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Niaz Banaei
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Roberto A Novoa
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Dora Y Ho
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Aruna K Subramanian
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Boling W. Surgery for Spine Disease and Intractable Pain. Brain Sci 2020; 10:E62. [PMID: 31991564 PMCID: PMC7071453 DOI: 10.3390/brainsci10020062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 11/16/2022] Open
Abstract
Painful conditions, particularly due to head pain, spinal disease, and neuropathic pain, are highly prevalent in modern society, resulting in a significant impact on the individual due to the disability of the condition and the direct cost of associated treatments [...].
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Affiliation(s)
- Warren Boling
- Department of Neurosurgery, Loma Linda University, Loma Linda, CA 92354, USA
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Bonifaz A, Estrada-Caraveo Y, Tirado-Sánchez A. Epidemiology of Endemic Mycosis in Children. CURRENT FUNGAL INFECTION REPORTS 2019. [DOI: 10.1007/s12281-019-00358-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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