Aspergillus vertebral osteomyelitis in an immunocompetent person

Ranjan, Rakesh; Mishra, Sachin; Ranjan, Shweta

doi:10.4103/0028-3886.72196

Cited by 14 publications

(8 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Spinal infection by Aspergillus is uncommon 910. Aspergillus species are ubiquitous saprophytic organisms.…”

Section: Discussionmentioning

confidence: 99%

“…Choice of treatment in fungal infection, especially aspergillus osteomyelitis, is debridement of necrotic bone in addition to the use of antifungal like Voriconazole, Itraconazole, Amphotericin B, and, possibly, 5-Fluorocytosine or Rifampin 710. In advanced cases, antimycotic drug therapy may not be effective and emergency surgical debridement may be indicated when the destruction is progressive and spinal cord compression is imminent or manifest.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Aspergillus vertebral osteomyelitis in immunocompetent patients

Sethi

Siraj

Kalra

et al. 2012

IJOO

View full text Add to dashboard Cite

Fungal infections are one of the important cause of morbidity and mortality in immunocompromised patients. Aspergillus vertebral osteomyelitis is extremely rare. We report two cases of aspergillus vertebral osteomyelitis in immunocompetent men in the absence of an underlying disorder. The clinical and radiological findings were suggestive of Pott's spine. The absolute CD4, CD8 counts and their ratio were normal. The HIV status was negative in both patients. Both patients underwent surgical decompression. The histopathology of tissue obtained were suggestive of aspergillus osteomyelitis. One patient had antifungal treatment for 3 months and was doing well at 1 year followup, whereas other patient did not turnup after 2 months.

show abstract

“…Spinal infection by Aspergillus is uncommon 910. Aspergillus species are ubiquitous saprophytic organisms.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Aspergillus vertebral osteomyelitis in immunocompetent patients

Sethi

Siraj

Kalra

et al. 2012

IJOO

View full text Add to dashboard Cite

show abstract

“…Osteomyelitis can occur by direct implantation (either traumatic or iatrogenic), hematogenous spread or by contiguity. There are very few case reports of Aspergillus osteomyelitis in an immunocompetent patient,[7] with most of the case reports showing involvement of the spine.…”

Section: Discussionmentioning

confidence: 99%

Case report of Aspergillus osteomyelitis of the ribs in an immunocompetent patient

D'sa

Singh

Satyendra

et al. 2013

J Global Infect Dis

View full text Add to dashboard Cite

Aspergillus is a saprophytic fungus which is universally found in the environment. Most people breathe in the spores of Aspergillus every day without development of disease. It commonly affects immunocompromised hosts. There are only few reported cases in an immunocompetent host. It most commonly affects the respiratory system, causing superficial or invasive disease. It also affects the skin, brain and eye in severely immunocompromised patients. Aspergillosis of the bone is extremely rare. Amongst all the reported cases of invasive aspergillosis the incidence of osteomyelitis is less than three percent. In these cases commonly of the spine is reported. We present a case of Aspergillus osteomyelitis of the ribs in an immunocompetent host.

show abstract

“…1 Several authors reported difficulty in diagnosis of Aspergillus vertebral osteomyelitis in immunocompetent patients until open surgical biopsy or needle biopsy was performed. [8][9][10][11] Treatment of invasive aspergillosis with osteomyelitis should include antifungal therapy, correction of immunosuppression if possible, and surgical source control. There were fewer relapses in patients managed with surgery plus antifungal therapy in comparison with antifungal therapy alone.…”

Section: Reviewedmentioning

confidence: 99%

Invasive Aspergillosis Manifested as Lumbar Vertebral Osteomyelitis in an Immunocompetent Man

Soule

Bearman

2016

Infect Dis Clin Pract

View full text Add to dashboard Cite

Aspergillus, a saprophytic fungus ubiquitously present in the environment, is rarely pathogenic in immunocompetent hosts, as such invasive Aspergillus osteomyelitis in immunocompetent hosts is uncommonly reported. A 50-year-old immunocompetent man, intravenous drug user with hepatitis C and diabetes mellitus, presented with lumbago and was diagnosed with L5-S1 discitis/osteomyelitis with associated phlegmon, s1 nerve root impingement, and no epidural abscess in August 2014. Needle biopsy cultures were negative. The patient was readmitted in October 2014 with worsening lumbago after completion of antibiotics. Inflammatory markers were significantly elevated (erythrocyte sedimentation rate = 97 mm in 1 hour; C-Reactive Protein = 13.5 mg/dL) and magnetic resonance imaging demonstrated ongoing acute L5-S1 discitis/osteomyelitis with involvement of vertebral bodies and endplate erosion, progressive impingement of the s1 nerve root, and no epidural abscess. Intraoperative cultures and histopathology were consistent with invasive aspergillosis and was treated successfully with voriconazole. Lumbar vertebral osteomyelitis in immunocompetent patients is a potentially life-threatening diagnosis often made late in the presentation because of nonspecific serologic test options and difficulty culturing fungal organisms. Open biopsy should be obtained when suspicion for a nonbacterial pathogen is high, especially after failure of antibacterial therapy. Aspergillosis should be considered in patients with a history of intravenous drug use, because drugs can be contaminated with Aspergillus. Voriconazole is the antifungal of choice for invasive aspergillosis osteomyelitis with excellent oral bioavailability, bone penetrance, and superior adverse effect profile compared with amphotericin B. Treatment for invasive aspergillosis osteomyelitis should involve both surgical and medical interventions.A spergillus is a saprophytic fungus and often found in decaying organic debris and construction sites. 1 It is the most common mold infection worldwide and rarely pathogenic in immunocompetent hosts. We present a case of Aspergillus lumbar vertebral osteomyelitis in an immunocompetent man. CASE PRESENTATIONA 50-year-old man with hepatitis C, diabetes mellitus type 2, and intravenous drug use sought medical care in August 2014 after experiencing 4 weeks of lumbago. He initially presented to an outside facility where a lumbar spine computed tomography scan suggested osteomyelitis at L5-S1. He denied systemic symptoms but noted increasing lower back pain, worse with ambulation, radicular pain, and plantar anesthesia of the left foot. He was then started on empiric vancomycin and piperacillin/tazobactam and transferred to our facility. A lumbar spine magnetic resonance imaging demonstrated changes consistent with L5-S1 discitis/ osteomyelitis, impingement of the s1 nerve root, but without epidural abscess. At the time of initial presentation, inflammatory markers were not elevated (erythrocyte sedimentation rate [ESR] = 15 mm in 1 hour; CRP = ...

show abstract

Aspergillus vertebral osteomyelitis in an immunocompetent person

Cited by 14 publications

References 1 publication

Aspergillus vertebral osteomyelitis in immunocompetent patients

Aspergillus vertebral osteomyelitis in immunocompetent patients

Case report of Aspergillus osteomyelitis of the ribs in an immunocompetent patient

Invasive Aspergillosis Manifested as Lumbar Vertebral Osteomyelitis in an Immunocompetent Man

Contact Info

Product

Resources

About