PMC9851880_01
A 3 x 4 cm ulcerating lesion with purulent drainage on the left lower extremity.
gr1.jpg
PMC9851880_01_gr1.jpg
fig1
On examination, the patient was febrile with tachycardia and had a 1 x 1 cm ulcerating left clavicular lesion, two 5 x 6 cm soft masses on right lower back, and left lower extremity with 3 x 4 cm ulcerating lesion with purulent drainage on dorsal foot (Fig. 1).
CT radiography of the chest, abdomen, pelvis, head, spine, showing diffuse fluid collections involving the soft tissues and muscles of the abdomen and pelvis, along with focal lytic lesion in the right temporal bone with adjacent focal meningeal thickening, as well as lytic lesions on iliac and sacroiliac regions of the spine.
gr2.jpg
PMC9851880_01_gr2.jpg
fig2
Computed topography (CT) of the head, chest, abdomen, pelvis, spine, and lower extremity showed focal lytic lesion in the right temporal bone with adjacent focal meningeal thickening, probable diffuse metastatic disease involving the soft tissues and muscles of the abdomen and pelvis as well as the lumbar, sacral, and Iliac bones (Figs. 2 and 3).
CT radiography of the chest, abdomen, pelvis, head, spine, showing diffuse fluid collections involving the soft tissues and muscles of the abdomen and pelvis, along with focal lytic lesion in the right temporal bone with adjacent focal meningeal thickening, as well as lytic lesions on iliac and sacroiliac regions of the spine.
gr3.jpg
PMC9851880_01_gr3.jpg
fig3
Computed topography (CT) of the head, chest, abdomen, pelvis, spine, and lower extremity showed focal lytic lesion in the right temporal bone with adjacent focal meningeal thickening, probable diffuse metastatic disease involving the soft tissues and muscles of the abdomen and pelvis as well as the lumbar, sacral, and Iliac bones (Figs. 2 and 3).
Cytology slide of fluid drained from the lumbar back stained with Grocott's methenamine silver revealed spherules (~12 mum) consistent with Coccidioides.
gr4.jpg
PMC9851880_01_gr4.jpg
fig4
Cytology slides from the lumbar abscess collection were stained with Grocott's methenamine silver and revealed spherule granules (~12 mum) consistent with Coccidioides (Fig. 4).