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Nonoperative Treatment of Vertebral Blastomycosis Osteomyelitis Associated with Paraspinal Abscess and Cord CompressionA Case Report
Jonathan R. Gottlieb, MD1; Frank J. Eismont, MD1
1 Department of Orthopaedics and Rehabilitation (D-27), University of Miami/Jackson Memorial Medical Center, P.O. Box 016960, Miami, FL 33101. E-mail address for J.R. Gottlieb: jrgottlieb@netzero.net
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Department of Orthopaedics and Rehabilitation, University of Miami/Jackson Memorial Medical Center, Miami, Florida

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Apr 01;88(4):854-856. doi: 10.2106/JBJS.E.00650
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Extract

Fungal infections of the spine are uncommon and usually result from hematogeneous spread of a primary focus1. Blastomyces dermatitidis has been described as a causative agent in cases of vertebral osteomyelitis2,3. Most cases of blastomycosis osteomyelitis begin as primary fungal infections of the lungs3. However, traumatic innoculation, local extension, and lymphatic spread also have been described as possible mechanisms of introduction of the fungi to bone2. The long bones are more commonly affected than the vertebral column is4. Primary cutaneous blastomycosis can occur5, and many other organ systems, including the genitourinary and central nervous systems, can be affected6.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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