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Fungal osteomyelitis with vertebral re-ossification
INTRODUCTION: We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. PRESENTATION OF CASE: A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR im...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756086/ https://www.ncbi.nlm.nih.gov/pubmed/26692163 http://dx.doi.org/10.1016/j.ijscr.2015.11.031 |
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author | O′Guinn, Devon J. Serletis, Demitre Kazemi, Noojan |
author_facet | O′Guinn, Devon J. Serletis, Demitre Kazemi, Noojan |
author_sort | O′Guinn, Devon J. |
collection | PubMed |
description | INTRODUCTION: We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. PRESENTATION OF CASE: A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR imaging confirmed a right-sided pre-/paravertebral soft tissue mass and destructive lytic lesions from T2 to T6. CT-guided needle biopsy confirmed granulomatous pulmonary Blastomycosis. Conservative management with antifungal therapy was initiated. Neurosurgical review confirmed no clinical or profound radiographic instability, and the patient was stabilized with TLSO bracing. Serial imaging 3 months later revealed near-resolution of the thoracic soft tissue mass, with vertebral re-ossification from T2 to T6. DISCUSSION: Fungal osteomyelitis presents a rare entity in the spectrum of spinal infections. In such cases, lytic spinal lesions are classically seen in association with a large paraspinous mass. Fungal infections of the spinal column may be treated conservatively, with surgical intervention reserved for progressive cases manifesting with neurological compromise and/or spinal column instability. Here, we found unexpected evidence for vertebral re-ossification across the affected thoracic levels (T2-6) in response to IV antibiotic therapy and conservative bracing, nearly 3 months later. |
format | Online Article Text |
id | pubmed-4756086 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-47560862016-03-02 Fungal osteomyelitis with vertebral re-ossification O′Guinn, Devon J. Serletis, Demitre Kazemi, Noojan Int J Surg Case Rep Case Report INTRODUCTION: We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. PRESENTATION OF CASE: A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR imaging confirmed a right-sided pre-/paravertebral soft tissue mass and destructive lytic lesions from T2 to T6. CT-guided needle biopsy confirmed granulomatous pulmonary Blastomycosis. Conservative management with antifungal therapy was initiated. Neurosurgical review confirmed no clinical or profound radiographic instability, and the patient was stabilized with TLSO bracing. Serial imaging 3 months later revealed near-resolution of the thoracic soft tissue mass, with vertebral re-ossification from T2 to T6. DISCUSSION: Fungal osteomyelitis presents a rare entity in the spectrum of spinal infections. In such cases, lytic spinal lesions are classically seen in association with a large paraspinous mass. Fungal infections of the spinal column may be treated conservatively, with surgical intervention reserved for progressive cases manifesting with neurological compromise and/or spinal column instability. Here, we found unexpected evidence for vertebral re-ossification across the affected thoracic levels (T2-6) in response to IV antibiotic therapy and conservative bracing, nearly 3 months later. Elsevier 2015-12-08 /pmc/articles/PMC4756086/ /pubmed/26692163 http://dx.doi.org/10.1016/j.ijscr.2015.11.031 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report O′Guinn, Devon J. Serletis, Demitre Kazemi, Noojan Fungal osteomyelitis with vertebral re-ossification |
title | Fungal osteomyelitis with vertebral re-ossification |
title_full | Fungal osteomyelitis with vertebral re-ossification |
title_fullStr | Fungal osteomyelitis with vertebral re-ossification |
title_full_unstemmed | Fungal osteomyelitis with vertebral re-ossification |
title_short | Fungal osteomyelitis with vertebral re-ossification |
title_sort | fungal osteomyelitis with vertebral re-ossification |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756086/ https://www.ncbi.nlm.nih.gov/pubmed/26692163 http://dx.doi.org/10.1016/j.ijscr.2015.11.031 |
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