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Pediatric spinal blastomycosis: case report

M Hardjasudarma1, B Willis, C Black-Payne

  • 1Department of Radiology, Louisiana State University Medical Center, Shreveport, USA.

Neurosurgery
|September 1, 1995
PubMed
Summary
This summary is machine-generated.

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Blastomyces dermatitidis caused vertebral destruction and epidural mass in a child. Gadolinium-enhanced MRI revealed a solid mass, simplifying treatment by avoiding surgical drainage.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Radiology

Background:

  • Blastomycosis is a fungal infection endemic to North America.
  • Vertebral blastomycosis is rare, often presenting with non-specific symptoms.
  • Diagnosis can be challenging due to varied clinical presentations.

Observation:

  • A 5-year-old male presented with flank pain, limping, weight loss, and cachexia.
  • Imaging showed destructive vertebral changes, epidural mass, and psoas abscesses.
  • Notably, intervertebral disc spaces were spared.

Findings:

  • Blastomyces dermatitidis was identified via needle aspiration.
  • The unusual sparing of disc spaces suggested paravertebral spread.
  • Gadolinium-enhanced MRI indicated a predominantly solid epidural mass.

Related Experiment Videos

Implications:

  • This case highlights an atypical presentation of vertebral blastomycosis.
  • MRI findings guided non-surgical management, avoiding invasive procedures.
  • Early and accurate diagnosis is crucial for effective treatment of fungal vertebral osteomyelitis.