Radiological Reasoning: Miliary Disease, Vertebral Osteomyelitis, and Soft-Tissue Abscesses

Abstract

Disseminated coccidioidomycosis in a nonendemic area can be difficult to diagnose, even with an excellent clinical history, as almost every organ system can be involved. Widespread disease can be seen and spinal involvement can easily be mistaken for malignancy, Pott's disease, or other granulomatous disease. Miliary disease with concomitant breast involvement is a rare presentation of disseminated disease. Detection of specific radiographic patterns of involvement and recognition of travel to or from an endemic area can lead to an accurate diagnosis and earlier treatment.