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Case 209: Disseminated coccidioidal spondylodiskitis
Brandon D Mirochnik1, Steven Lev, Ephram P Weingarten
1From the Department of Radiology, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554.
Radiology
|August 26, 2014
Summary
A 46-year-old man with diabetes and hepatitis C presented with back pain. Diagnostic imaging and lab tests revealed hypergammaglobulinemia, suggesting chronic inflammation.
Area of Science:
- Internal Medicine
- Infectious Diseases
Background:
- A 46-year-old Hispanic male with a history of diabetes and hepatitis C presented with a 3-month history of back pain.
- The patient had recently immigrated from Mexico.
Observation:
- Physical examination was unremarkable.
- Laboratory results showed a high white blood cell count (11.2 ×10(9)/L), elevated neutrophils (81.3%), low hemoglobin (7.9 g/dL), low hematocrit (23.2%), and low calcium (8.3 mg/dL).
- Protein electrophoresis indicated hypergammaglobulinemia, consistent with chronic inflammation.
Findings:
- Computed tomography (CT) and magnetic resonance (MR) imaging of the spine were performed.
- The findings from imaging studies were not detailed in the provided abstract.
Implications:
- The combination of symptoms, laboratory findings, and imaging suggests a need for further investigation into the cause of chronic inflammation and back pain.
- This case highlights the importance of considering infectious etiologies in patients with unexplained back pain and abnormal laboratory findings, especially in immigrant populations.
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