CTICasesBlastomycosis Osteomyelitis of the Tibia
Imaging findings
Tibia radiograph and CT show a lytic, geographic lesion in the proximal tibial metaphysis with extensive surrounding soft tissue inflammatory edema. Chest CT shows a mass-like pulmonary consolidation. Cultures grew Blastomyces dermatitidis.
Key takeaways
Blastomycosis is a dimorphic fungus endemic to the Ohio and Mississippi River valleys. In children, it can disseminate to bones, presenting as lytic bone lesions with marked surrounding soft tissue inflammation. This presentation can mimic osteosarcoma or bacterial osteomyelitis.
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