CTICasesDisseminated coccidioidomycosis
Imaging findings
Chest CT and MR spine show extensive, necrotic, low-attenuation mediastinal lymphadenopathy, diffuse miliary lung nodules, a paraspinal psoas abscess, and barium swallow demonstrating an esophagomediastinal fistula communicating between the esophageal lumen and a necrotic subcarinal lymph node.
Key takeaways
Coccidioidomycosis can disseminate to bones, spine, and mediastinum in susceptible populations. Like tuberculosis, it can form fistulas between adjacent structures, such as an esophagomediastinal or esophagobronchial fistula.
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