The disease has 3 forms, cervicofacial, pulmonary and abdominal. Pulmonary forms are becoming more common. Spinal involvement is always secondary to an infection of contiguous tissue, rarely destroys the discs. Vertebral body destruction and new bone formation give honey comb appearance. Penicillin for 3 - 4 months is recommended.
Prognosis is much better than the true fungi infection.
Single or multiple abscesses which may rupture causing purulent meningitis. CSF finding are non specific and culture is difficult. It is penicillin resistant. Culture is difficult. Spinal form is rare.