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Fungal Spine Infections - Endemic Mycoses and Treatment

Spinal Infections

A 52-year-old previously healthy man from Arizona presents with 4 months of progressive back pain and weight loss. He has no history of immunosuppression. MRI shows T11-L1 vertebral osteomyelitis with paravertebral abscess. CT shows lytic lesions with preservation of disc spaces. Serology is positive for Coccidioides antibodies. Biopsy reveals spherules with endospores. Regarding coccidioidomycosis of the spine:

Mark each as TRUE or FALSE

A

Coccidioidomycosis is caused by Coccidioides immitis and C. posadasii, endemic to the southwestern U...

B

Spinal coccidioidomycosis occurs in approximately 0.5-1% of symptomatic infections; it can affect im...

C

Coccidioidomycosis only affects immunocompromised patients; the lumbar spine is never involved; disc...

D

Diagnosis is made by serology (complement fixation, immunodiffusion, EIA), tissue biopsy showing cha...

E

Treatment of spinal coccidioidomycosis includes fluconazole 400-800mg daily as first-line for most c...

Answer the questions to see explanations

Click T (True) or F (False) for each option