OBJECT: This study was conducted to review the presentation and management of @entity1 with @entity6656 involving the spine. METHODS: The authors reviewed 23 cases of @entity6656 treated at their institutions. There were 20 males and three females who ranged in age from 9 to 62 years. Non-Caucasian individuals were disproportionately represented. @entity66 was the first manifestation of @entity6656 in 10 cases. Thirteen @entity1 with @entity693 , soft-tissue involvement, or @entity358 developed new spinal lesions despite undergoing continued systemic therapy with @entity2379 and/or @entity2380 . In all @entity1 computerized tomography and magnetic resonance imaging studies demonstrated preferential involvement of the disc spaces, vertebral bodies, and pedicles with extensive paravertebral phlegmons and retropharyngeal, mediastinal, or @entity4340 abscesses. Despite the significant imaging findings, only four @entity1 presented with a significant @entity51 . Local @entity158 or @entity614 was the most common complaint. Twenty @entity1 underwent invasive therapy. In five @entity1 with prominent @entity4340 abscesses and disc space disease, drainage was performed after inserting a percutaneous catheter. Progressive @entity79 necessitated debridement and fusion in one of these @entity1 , and two others had poor outcomes after receiving antifungal therapy alone. Initially 15 @entity1 underwent debridement and fusion in which instrumentation (10 cases) or bone graft alone was used (five cases). One @entity1 worsened neurologically after surgery, and another @entity1 required reoperation for a failed fusion and to correct progressive @entity1513 . Four of the 23 @entity1 died of complications related to @entity12045 . Most of the 15 surviving @entity1 have required long-term antifungal therapy for spinal and extraspinal foci. CONCLUSIONS: @entity6656 can be an aggressive disease process. Systemic antifungal therapy fails to prevent de novo spinal involvement and is usually insufficient treatment for established @entity66 .

Clinical presentation, radiological findings, and treatment results of XXXX involving the spine: report on 23 cases.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['Spinal disease', 'spinal disease'] @entity2379 :: ('MESH:D000666', 'Chemical') :: ['amphotericin'] @entity2380 :: ('MESH:D015725', 'Chemical') :: ['fluconazole'] @entity4340 :: ('MESH:D016659', 'Disease') :: ['psoas'] @entity1513 :: ('MESH:D007738', 'Disease') :: ['kyphosis'] @entity693 :: ('MESH:D008581', 'Disease') :: ['meningitis'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficit'] @entity79 :: ('MESH:D001847', 'Disease') :: ['bone destruction'] @entity358 :: ('MESH:D008171', 'Disease') :: ['pulmonary involvement'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity6656 :: ('MESH:D003047', 'Disease') :: ['coccidioidomycosis', 'Spinal coccidioidomycosis', 'spinal coccidioidomycosis', 'disseminated coccidioidomycosis'] @entity614 :: ('MESH:D011843', 'Disease') :: ['radiculopathy'] @entity12045 :: ('MESH:D016469', 'Disease') :: ['fungemia']
@entity6656 :: (MESH:D003047,Disease) :: ['coccidioidomycosis']
