Medical vs surgical management of spinal epidural abscess.

Background: We compared the clinical features and outcomes of patients with spinal epidural abscess treated with prolonged parenteral antibiotics alone or combined with computed tomography-guided percutaneous needle aspiration drainage with those of patients undergoing surgical decompression.

Methods: A retrospective analysis of 57 cases of spinal epidural abscess treated at an academic teaching hospital during a 14-year period.

Results: The lumbar region was most frequently involved, and 46% of patients were immunocompromised.

Recurrent blastomycosis of the central nervous system: case report and review.

Although blastomycosis of the central nervous system (CNS) occurs in approximately 4% of patients with blastomycosis, recurrent CNS blastomycosis is very rare. We review the clinical features, treatment, and outcome of 4 previously reported cases. We also report a case of recurrent CNS blastomycosis successfully treated with surgery and liposomal amphotericin B after an inadequate response to amphotericin B therapy.

Female genital coccidioidomycosis (FGC), Addison's disease and sigmoid loop abscess due to Coccidioides immites; case report and review of literature on FGC.

We describe a woman with unusual complications of infection with Coccidioides immitis--infection of the genital tract and adrenal insufficiency. The patient also had intestinal coccidioidomycosis (cocci) in conjunction with presumed pulmonary, and asymptomatic central nervous system cocci. To our knowledge, concurrent FGC, intestinal and adrenal cocci have not been reported previously.