[Osteoarticular coccidioidomicosis. Clinical and pathological study of 36 Mexican patients].
Coccidioidomycosis (CM) is primarily a lung disease. Systemic spread occurs in 1% of cases and one of its manifestation is osteoarthritis.


OBJECTIVE
To describe the clinical and pathological characteristics of 36 patients with osteoarthritis by Coccidioides immitis (COA).


METHODS
The surgical pathology records of two medical institutions were reviewed; patients with clinical diagnosis of osteoarthritis and definitive histopathological diagnosis of COA were included in the study. Results were analyzed by contingence tables (RXC) and chi2 test.


RESULTS
Twenty six adults (19 men, seven women) and 10 children (seven males, three females) were studied. The chi2 analysis demonstrated a predominance of disease in men (72.2%, p = 0.008). There was no difference between males and females in relation to history of mycotic disease or diagnosis of lung disease after the diagnosis of COA. Bone involvement (76% of cases) was more frequent that pure joint lesions and the predominant radiological lesion was of lytic type. 30.5% of patients (11 cases) had multiple bone lesions and eight of them were men with multiple vertebral bone lesions.


CONCLUSIONS
The COA was the only manifestation of disease in 83% of the patients. Therefore is important to consider this etiology in patients of endemic area. The clinical and radiological spectrum of COA is wide and may include a dentigerous and synovial cyst or simulates metastatic disease. The recognition of the clinical manifestations of COA may contribute to an opportune diagnosis and treatment.
Torres-Nájera
Manuel
M
Hospital de Traumatología y Ortopedia No 21, IMSS.
de la Garza-Galván
Sergio
S
Cerda-Flores
Ricardo M
RM
Nocedal-Rustrián
Fausto C
FC
Calderón-Garcidueñas
Ana Laura
AL
D000293:Adolescent; D000368:Aged; D001170:Arthritis, Infectious / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D001845:Bone Cysts / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D001850:Bone Diseases, Infectious / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003047:Coccidioidomycosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008172:Lung Diseases, Fungal / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000382:microbiology; D010014:Osteolysis / Q000209:etiology / Q000382:microbiology; D010019:Osteomyelitis / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D012189:Retrospective Studies