Spondylodiscitis by Aspergillus nidulans: A Diagnostic Challenge

Abstract

Fungal infections are significant causes of morbidity and mortality in immunocompromised patients. Aspergillus spondylodiscitis is an uncommon manifestation of invasive aspergillosis and a significant cause of death and frailty.We report a case of spondylodiscitis caused by Aspergillus nidulans section in an HIV patient with Burkitt's lymphoma, who presented with long-term lower back pain and weakness of the lower limbs. Initial MR imaging missed the lesion. Emergent decompression surgery was performed. Fungal culture on the vertebral disc revealed the agent that was later confirmed by sequencing the ITS region of ribosomal DNA genes. Voriconazole was the chosen treatment, and the patient improved. This case demonstrates how difficult a diagnosis can be if we are not considering it.

A Case Report of Aspergillus Fungal Spinal Infection in Immunocompetent Patient and Review of Literature

“…Aspergillosis infection of spine is rarely encountered. Early diagnosis of fungal spinal infection is difficult and it is aggressive infection which may lead to spinal instability, neurological deficit, cauda equina syndrome and death [2,3].…”