Coccidioidomycosis Infection Presenting With Thoracic Spinal Pain

Abstract

Thoracic pain that originates from thoracic spine pathology is uncommon, and it is reported to represent not more than 5% of all common spinal pain symptoms [1]. Presentations of thoracic spinal pain include “band-like” chest pain, focal pain in the mid back, and pain on deep breathing [1]. Given the paucity of primary thoracic spine pathologies, persistent thoracic pain should prompt consideration of serious conditions such as spinal infection; malignant neoplasm; traumatic or nontraumatic vertebral compression fractures; and extraspinal pathologies, such as rib fractures, peptic ulcer disease, pancreatitis, cholecystitis, pleuritis, and aortic aneurysms [1]. The incidence of infectious spondylodiskitis in developed countries is 4-24 per million each year [2]. Spondylodiskitis in adults is considered very rare; it usually follows surgical interventions or presents in cases of generalized septicemia [3]. In this report, we present a patient who described a new onset of thoracic pain that progressed without improvement, the evaluation that led to the diagnosis of coccidioidomycosis diskitis and vertebral osteomyelitis, and the course of treatment. We also discuss the diagnostic and therapeutic options and previous reports of this pathology.