Miliary coccidioidomycosis mimicking tuberculosis: Case report and review of literature.

Miliary coccidioidomycosis is a severe manifestation of diseases caused by Coccidioides immitis and Coccidioides posadasii that is endemic to the southwestern United States as well as Central and South America. While most cases of coccidioidomycosis present with pulmonary disease, certain risk factors increase the risk for disseminated disease. We present a case of miliary coccidioidomycosis in a 46-year-old patient with uncontrolled diabetes. Additionally, we review the features of thirty-seven cases of patients with miliary coccidioidomycosis.

Vertebral osteomyelitis secondary to Streptococcus cristatus infection.

A 66-year-old male with a history of low back pain was found to have discitis and osteomyelitis. Biopsy and PCR testing revealed Streptococcus cristatus infection. This bacteria does not typically cause disease, and only a few cases in the literature have reported it to cause infection in the bones or joints. This case illustrates that vertebral osteomyelitis with a rare causative agent, S. cristatus, is possible and can be identified with PCR. Treatment typically requires long-term antibiotics tailored to the causative agent for a minimum of 6 weeks and can sometimes include surgical management.

Fungal perianal abscess as the initial presentation of disseminated coccidioidomycosis.

Coccidioides is a dimorphic fungus that can cause various clinical presentations, mainly pulmonary, skin, musculoskeletal, and in the central nervous system; most reports are in the southwestern area of the USA. We present a case of a young male with a perianal abscess in the absence of any pulmonary or constitutional symptoms. Perianal abscess as initial manifestation is a novel presentation of coccidioidomycosis in the literature.