Aaron Richterman, MD, MPH; Melissa Richard-Greenblatt, PhD; Kathryn Whitaker, MD
JAMA. 2021;326(20):2070-2071. doi:10.1001/jama.2021.17584
A 46-year-old man with a history of travel to India had 3 months of upper back pain and 2 weeks of dry cough and subjective fevers that did not improve with empirical azithromycin. Chest CT showed a dense consolidation in the left lower lobe; MRI showed a paraspinal mass with extensive contrast enhancement in the lower thoracic vertebral bodies and relative sparing of the disks. What is the diagnosis and what would you do next?