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Musculoskeletal coccidioidomycosis.
Mihra S Taljanovic1, Rodney D Adam
1Department of Radiology, University of Arizona, Tucson, Arizona, USA. mihrat@radiology.arizona.edu
Seminars in Musculoskeletal Radiology
|November 15, 2011
Summary
Coccidioidomycosis, or valley fever, is a fungal infection endemic to the Americas. Skeletal involvement is common in disseminated cases and requires prolonged treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Rheumatology
Background:
- Coccidioidomycosis (valley fever) is a systemic fungal infection caused by Coccidioides species, endemic in the Americas.
- Risk factors include specific ethnicities, male gender, and immunosuppression.
- Primary infection is pulmonary, with disseminated disease occurring in less than 1% of cases.
Purpose of the Study:
- To review the diagnosis and management of musculoskeletal coccidioidomycosis.
- To highlight the role of imaging in diagnosis and follow-up.
- To discuss treatment challenges and strategies for skeletal coccidioidomycosis.
Main Methods:
- Review of diagnostic methods including culture, cytology, histology, and serology.
- Discussion of imaging modalities: radiography, MRI, CT, and bone scintigraphy.
- Analysis of treatment approaches combining medical therapy and surgical debridement.
Main Results:
- Skeletal coccidioidomycosis occurs in 10-50% of disseminated cases, often affecting the axial skeleton.
- Imaging is crucial for diagnosis and monitoring treatment response.
- Treatment is challenging, requiring prolonged or lifelong medical therapy and often surgical intervention.
Conclusions:
- Musculoskeletal coccidioidomycosis is a serious complication of valley fever.
- Early diagnosis and comprehensive management are essential.
- Long-term medical therapy, potentially lifelong, is frequently necessary for successful treatment.
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