Aspergillus spondylodiscitis in an immunocompetent paraplegic patient

Abstract

A case of an immunocompetent 60 year old patient is reported, who suered extensive thoracic spinal injury and paraplegia after polytrauma. In the course of rehabilitation he developed aspergillus spondylodiscitis in a part of the thoraco-lumbar spine which was primarily uninjured. The diagnostic assessment and therapeutic approach of this rare disorder is elucidated and discussed in the context of paraplegia and polytrauma. Possible mechanisms of inoculation and spreading of the moulds as well as predisposing factors of the disease are discussed in this paper and a review of the recent literature is provided.

Aspergillus spondylitis in immunocompetent patients

“…We have reported successful incorporation of allografts in spinal tuberculosis and in this study, the allografts incorporated with no evidence of rejection or late infection [5]. Several studies have shown that surgery together with antifungal treatment is most effective in managing Aspergillus osteomyelitis [7,9,12].…”

“…The most commonly implicated species is Aspergillus fumigatus and less commonly A. flavus, A. niger, A. nodulans and A. terreus have been isolated [7]. The radiological features of Aspergillus spondylitis are non-specific and they may involve single or multiple bodies, present as primary discitis and as extradural extraosseous infection [4,7,10,12]. The preoperative clinical and radiological diagnosis was tuberculous spondylitis in 3 of our patients since spinal tuberculosis is endemic in our region and moreover there are no distinguishing radiological characteristics in differentiating it from Aspergillus spondylitis.…”

“…Isolated Aspergillus osteomyelitis may occur without evidence of systemic disease but rarely in the absence of a detectable underlying disorder [4,7,12]. We report on four normal hosts who developed Aspergillus osteomyelitis of the spine, which was successfully treated with surgery and antifungal therapy.…”

A Rare Case of Aspergillus Spondylodiscitis In B-Cell Acute Lymphoid Leukemia

“…It is frequently misdiagnosed at first presentation because to its potentially delayed start and non-specific clinical symptoms [2]. Medical therapy alone or surgery with medical therapy is the mainstay of treatment [3,4]. Here, we report the case of an immunocompromised 53-year-old male with L4-L5 spondylodiscitis caused by Aspergillus.…”