PubMed · 4913271
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W R Fair, M H Higgins. 1970. Renal abscess.. https://doi.org/10.1016/s0022-5347(17)61695-1
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Infection of the thyroid gland with Coccidioides immitis, the causative agent of coccidioidomycosis, is very rarely recognized antemortem. We report 2 recent cases, one immunosuppressed by corticosteroid treatment of sarcoidosis and the other without any recognized impairment of host defenses. In the first case, thyroid gland involvement was but 1 indication of disseminated infection. In the second case, the patient appeared to have autoimmune thyrotoxicosis without clinical evidence of coccidioidomycosis elsewhere. Although historical autopsy studies have indicated that coccidioidal involvement of the thyroid gland can infrequently occur as part of fatal disseminated infection, to our knowledge only 2 other cases of infection detected during life have been reported. Optimal treatment of this rare complication of coccidioidomycosis is uncertain.
STUDY DESIGN: This case report describes a middle-aged woman with concomitant tuberculosis and pyogenic infection of the cervical spine. OBJECTIVE: To describe an unusual case of concomitant tuberculosis and pyogenic infection of the cervical spine. SUMMARY OF BACKGROUND DATA: Neither tuberculosis nor pyogenic spondylitis of the cervical spine is a common disorder. This case report describes a concomitant infection of C3-C4 in an otherwise healthy patient. To the authors' knowledge, such a case has never been reported. METHODS: This 52-year-old woman had spontaneous neck pain and myelopathy. Radiologic examination revealed the presence of an epidural abscess with destruction of C3-C4 vertebral bodies. RESULTS: Anterior decompression and fusion were performed, followed by therapy with antituberculosis drugs and antibiotics. The patient completely recovered. A follow-up radiograph revealed that solid fusion had been achieved. CONCLUSION: A case of concomitant tuberculosis and pyogenic infection of the cervical spine is presented. The possibility of this differential diagnosis should be considered, especially in areas of endemic tuberculosis. Examination of biopsy samples for histologic and bacteriologic findings is important to confirm this diagnosis. Radical debridement and combination therapy are strongly recommended to treat patients with this combination of infections.