Coccidioidomycosis of Bone and Joints

  • Stanley C. Deresinski
Part of the Current Topics in Infectious Disease book series (CTID)


Infection of bone or joint is one of the most frequent manifestations of dissemination in coccidioidomycosis, occurring in approximately 20% of cases.1 Joas Furtado-Silveira, the second reported patient with coccidioidomycosis, had osteomyelitis of the tibia and the head of a metacarpal, both with sinus formation. In addition, one of his metacarpal-phalangeal joints was “thoroughly disorganized.” Several years after Furtado-Silveira’s death, Ophuls, upon writing the first review of coccidioidal granuloma, noted that 5 of the first 12 patients reported, including Furtado-Silveira, had musculoskeletal involvement.2 These cases were, however, almost certainly not the first instances of coccidioidal infection, osseous or otherwise. Recent roentgenographic examination of the 1800year-old bones of an Indian of the San Joaquin Valley of California, where the climate has not changed significantly in 10,000 years, revealed a lytic lesion of the patella as well as a “moth-eaten” lesion of the distal femur, both very likely due to Coccidioides immitis. 3


Sinus Tract Joint Infection Joint Involvement Widespread Dissemination Vertebral Collapse 
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© Springer Science+Business Media New York 1980

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  • Stanley C. Deresinski

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