HUMAN disease induced by the fungus Coccidioides immitis is endemic to the southwestern United States. In the vast majority of persons affected, coccidioidomycosis affects only the respiratory tree. We report a case in which the condition presented as vertebral osteomyelitis resembles tuberculous spondylitis (Pott's disease). We wish to emphasize the similarities between these two entities and the importance of recognizing coccidioidomycosis in the differential diagnosis of Pott's disease.
Report of a Case
An 82-year-old man entered the Tucson Veterans Administration Hospital on November 15, 1976, with a four-month history of midthoracic back pain. He had first noted this discomfort following heavy exertion and lifting. During the two months prior to hospital admission there had been a 13-pound weight loss. He denied having cough, sputum production, fever, chills, or night sweats. The patient did recall a flu-like illness in January 1976, and in February 1976 a chest film had shown a
Wesselius LJ, Brooks RJ, Gall EP. Vertebral Coccidioidomycosis Presenting as Pott's Disease. JAMA. 1977;238(13):1397–1398. doi:10.1001/jama.1977.03280140075028
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