Candida osteomyelitis and disc space infection of the lumbar spine

Pl, Munk; Lee, MJ; Py, Poon; Jx, O'Connell; Db, Coupland; Dl, Janzen; Pm, Logan; Dvorak, Marcel F.

doi:10.1007/s002560050189

Cited by 34 publications

(12 citation statements)

References 6 publications

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“…In our case, decreased disc signal intensity was observed in three of six affected discs and intranuclear clefts were preserved in two of six affected discs. The minimal hyperintensity or isointensity of vertebrae on T2-weighted images observed in our case is consistent with the findings of previous reports (8, 9) on Candida or Aspergillus spondylitis.…”

Section: Discussionsupporting

confidence: 93%

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

et al. 2007

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Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient. spergillosis is a rare cause of spondylitis, and early diagnosis by MR imaging and adequate treatment are essential for a good outcome (1 3). Although the MR findings of bacterial spondylitis have been fully described (4, 5), the findings of aspergillus spondylitis have been rarely described, and to the best of our knowledge multilevel involvement of cervico-thoraco-lumbar spine has not been previously reported. Here, we report the MR imaging findings of aspergillus spondylitis involving the cervico-thoraco-lumbar spine in a liver transplant recipient. CASE REPORTA 46-year-old man underwent liver transplantation due to hepatitis B virus cirrhosis in March 2005, and subsequently was treated using routine immunosuppression therapy. However, his early postoperative course was complicated by pulmonary aspergillosis. About 10 weeks after liver transplantation a left lower lobe wedge resection and pathology showed aspergilloma, and about three weeks after this thoracic surgery the patient complained of back pain. Plain radiography of the lumbar spine demonstrated no abnormality, and although his back pain was treated conservatively, the patient complained of progressive back pain.MR imaging of the lumbar spine revealed band-like or diffuse hypointense signals in vertebral bodies L2 to L5 on T1-weighted images (Fig. 1A), which were isointense to slightly hyperintense on T2-weighted images (Fig. 1B). In detail, T1-weighted images showed some hypointense signals with preservation of intranuclear clefts in the L2 3 and L4 5 discs, but disc hyperintensity was absent and intranuclear cleft loss was visualized in the L3 4 disc. In addition, endplate irregularities were apparent in the involved spine. Disc space narrowing was observed at L3 4 and L4 5, and band-like or diffuse enhancement was observed in involved vertebral bodies with an epidural abscess (Fig. 1C). A paraspinal abnormal signal was relatively well-defined (Fig. 1D). The MR based diagnosis was of tuberculous spondylitis rather than pyogenic spondylitis. At surgery, infected granulation tissue and disc material with pus were found at the

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Section: Discussionsupporting

confidence: 93%

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

et al. 2007

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“…Diagnosis is generally supported by a compendium of clinical [46], radiological [47][48][49] and mycological evidence [50]. Efforts made to include the results of serological tests in this compendium have generally failed, despite consistent improvements in the sensitivity and specificity of these tests, particularly those detecting candidaderived molecules such as D-arabinitol [26], glucans [25] and mannan [24,51].…”

Section: Discussionmentioning

confidence: 99%

Combined detection of mannanaemia and anti-mannan antibodies as a strategy for the diagnosis of systemic infection caused by pathogenic Candida species

Sendid

Poirot

Tabouret

et al. 2002

Journal of Medical Microbiology

141

116

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“…2,3 Patients often present with spinal symptoms weeks to months after the episode of haematogenous spread that presumably was responsible of the spinal infection. 7 It has been reported in the literature that between weeks and more than 1 year may elapse between septicaemia and the time of definitive diagnosis of CSD by culture of the organism. 1 -3,7,10 In the present case the antecedent of bacteriaemia and the high frequency of staphylococcal spondylodiscitis were the reasons initially to consider it to be a pyogenic discitis, as also has happened in other reported cases.…”

Section: Discussionmentioning

confidence: 99%

Candida albicansspondylodiscitis

Ugarriza

Cabezudo

Lorenzana

et al. 2004

British Journal of Neurosurgery

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Candida spondylodiscitis is a rare complication of a haematogenous dissemination of a candida infection, that usually affects immunocompromised patients. We present a case of a Candida albicans spondylodiscitis in a patient in whom a bacterial origin was suspected because of the antecedent of a Staphylococcus aureus bacteriaemia. After unfavourable evolution with initial antibiotic treatment, the correct diagnosis was reached after culture of the material obtained from surgical debridement. The clinical, diagnostic features, and the literature are reviewed.

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Candida osteomyelitis and disc space infection of the lumbar spine

Cited by 34 publications

References 6 publications

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

Combined detection of mannanaemia and anti-mannan antibodies as a strategy for the diagnosis of systemic infection caused by pathogenic Candida species

Candida albicansspondylodiscitis

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