Spondylodiscitis Due to Aspergillus terreus in an Immunocompetent Host: Case Report and Literature Review

Comacle, Pauline; Govic, Yohann Le; Hoche-Delchet, Cyril; Sandrini, J.; Aguilar, Claire; Bouyer, Benjamin; Blanchi, Sophie; Penn, Pascale

doi:10.1007/s11046-016-0007-6

Cited by 21 publications

(19 citation statements)

References 26 publications

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“…[2,10]; however, patients with normal immune function but predisposing factors (pulmonary aspergillosis, tuberculosis, discectomy, diabetes, chronic obstructive pulmonary disease, fungal heart disease, endometritis, etc.) may also be affected [11,12]. The pathogenesis of Aspergillus spondylitis includes continuous spread to adjacent lung foci, exposure to contaminated blood, and direct inoculation (during trauma or surgery) [6].…”

Section: Discussionmentioning

confidence: 99%

Aspergillus spondylitis: case series and literature review

Dai

Wang

Yin

et al. 2020

BMC Musculoskelet Disord

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Background: Spinal fungal infections, especially spinal Aspergillus infections, are rare in the clinic. Here, we introduce the clinical features, diagnosis, treatment, and prognoses of 6 cases of Aspergillus spondylitis. Methods: We retrospectively analysed the complete clinical data of patients with Aspergillus spondylitis treated in our hospital from January 2013 to January 2020. Results: Aspergillus fumigatus was isolated in 4 cases, and Aspergillus spp. and Aspergillus niger were isolated in 1 case each. All six patients reported varying degrees of focal spinal pain; one patient reported radiating pain, one patient experienced bowel dysfunction and numbness in both lower limbs, and three patients had fever symptoms. One case involved the thoracic spine, one case involved the thoracolumbar junction, and 4 cases involved the lumbar spine. Three patients were already in an immunosuppressed state, and three patients entered an immunosuppressed state after spinal surgery. All six patients were successfully cured, and five required surgery. Of the 5 patients who underwent surgical treatment, 2 had spinal cord compression symptoms, and 3 had spinal instability. At the end of follow-up, 1 patient reported left back pain and 1 patient reported left limb numbness. Conclusion: The clinical manifestations of Aspergillus spondylitis are non-specific, and the diagnosis depends on typical imaging findings and microbiological and histopathological examination results. When there is no spinal instability, spinal nerve compression symptoms, or progressive deterioration, antifungal therapy alone may be considered. If spinal instability, spinal nerve compression, or epidural abscess formation is present, surgery combined with antifungal therapy is recommended.

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Section: Discussionmentioning

confidence: 99%

Aspergillus spondylitis: case series and literature review

Dai

Wang

Yin

et al. 2020

BMC Musculoskelet Disord

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“…Comacle et al . [1] reported a case of an immunocompetent 20-year-old man in whom the infection possibly arose from traumatic inoculation of the fungus during a previous motorbike accident.…”

Section: Discussionmentioning

confidence: 99%

“…There are few reports of vertebral infections involving A. terreus . To the best of our knowledge, only seven cases of spondylodiscitis caused by A. terreus have been reported previously in humans [1]. We report a case of a patient with A. terreus spondylodiscitis following an abdominal stab wound.…”

Section: Introductionmentioning

confidence: 94%

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Aspergillus terreus spondylodiscitis following an abdominal stab wound: a case report

et al. 2019

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Background Aspergillus terreus , a saprophytic fungus, is recognized as an emerging pathogen in various infections in humans. However, bone and joint involvement is uncommon. To the best of our knowledge, only seven cases of spondylodiscitis caused by Aspergillus terreus have been reported previously in humans. We report a case of a patient with Aspergillus terreus spondylodiscitis following an abdominal stab wound. Case presentation A 74-year-old Japanese man with no particular medical history fell from a ladder and sustained a left abdominal stab wound from an L-shaped metal peg. Computed tomography showed the trace of the L-shaped metal peg from the left abdomen to the left rib and left kidney. The scan also showed an anterolateral bone avulsion of the left side of the T12 vertebral body, as well as fractures of the L1 left transverse process and the left 10th–12th ribs. He was hospitalized and treated with conservative therapy for 6 weeks. He was readmitted to the hospital with complaints of sudden back pain, numbness of both legs, and inability to walk 13 weeks after the fall. Magnetic resonance imaging findings were typical of spondylodiscitis. Gadolinium-enhanced T1-weighted magnetic resonance imaging indicated increased signal intensity at T11–T12 vertebral bodies and severe cord compression and epidural abscess at T11–T12 associated with infiltration of soft paravertebral tissues. On the seventh day after admission, he underwent partial laminectomy at T11 and posterior fusion at T9 to L2. The result of his blood culture was negative, but Aspergillus terreus was isolated from the material of T11–T12 intervertebral disc and vertebral bodies. His Aspergillus antigen was positive in a blood examination. Histological examination showed chronic suppurative osteomyelitis. On the 35th day after admission, he underwent anterior fusion at T11 and T12 with a rib bone graft. For 5 months, voriconazole was administered, and he wore a rigid corset. Posterior partial laminectomy at T11 and anterior fusion at T11 and T12 resulted in a good clinical course. The patient’s neurological dysfunction was completely recovered, and his back pain disappeared. Two years after the operation, computed tomography was performed and showed bone fusion at T11 and T12. Magnetic resonance imaging revealed no evidence of increased signal intensity at T11–T12 vertebral bodies and severe cord compression and epidural abscess at T11–T12. Conclusions To our knowledge, this is the first report of spondylodiscitis caused by Aspergillus terreus after an abdominal penetrating injury. The histological finding of chronic suppurative osteomyelitis and the radiological findings strongly suggested direct inoculation of Aspergillus terreus .

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“…Severe paracoccidioidomycosis in a 14-year-old boy 200 1/1 [63] a Google Scholar/Scopus [41,42], France [43,44], India [45,46], Italy [47], Iran [48], Japan [49], Malaysia [50], Poland [51], UK [52], and USA [53,54]. There were no other discernible features among this group of case reports to account for the high downloads and citations except for a novelty or rarity of fungal pathogens, for example reports of two cases of multidrug-resistant yeast (Fereydounia khargensis) and of black-grain eumycetoma caused by the rare fungal pathogen Medicopsis romeroi [50,52].…”

Section: High Downloads and Citationsmentioning

confidence: 99%

The Curious Case of “Case Report” of Infections Caused by Human and Animal Fungal Pathogens: An Educational Tool, an Online Archive, or a Format in Need of Retooling

Bouchara

Chaturvedi

2018

Mycopathologia

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Case reports describe the unusual occurrence and complications of diseases, diagnostic challenges, and notable therapeutic successes. Some journals have discontinued the case reports, while new case report journals have appeared in recent years. During the eightieth anniversary of Mycopathologia, it is fitting to examine the relevance of the case report since the journal continues to traverse the boundaries of basic and clinical sciences. A random sample of recent case reports and other articles were selected from Mycopathologia. Springer Nature individual article download statistics, and Google Scholar and Scopus citations numbers were compared to assess the reader access and bibliometric impact of case reports. Our analysis indicated that the case report format continues to be a vital element of publication in a cross-disciplinary journal such as Mycopathologia. Medical and veterinary case reports covering fungal pathogens are widely read as evident from their download numbers. The download numbers have a positive correlation with the completeness of the report, the topics and geographic origin of reports have a neutral influence, and the recency leads to lower downloads. There is no discernible trend between the download numbers and the citations of case reports as measured by Google Scholar and Scopus. A specially designed checklist for Mycopathologia case reports and new format MycopathologiaIMAGES are being introduced to improve the quality and relevance of case reports further.

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Spondylodiscitis Due to Aspergillus terreus in an Immunocompetent Host: Case Report and Literature Review

Cited by 21 publications

References 26 publications

Aspergillus spondylitis: case series and literature review

Aspergillus spondylitis: case series and literature review

Aspergillus terreus spondylodiscitis following an abdominal stab wound: a case report

The Curious Case of “Case Report” of Infections Caused by Human and Animal Fungal Pathogens: An Educational Tool, an Online Archive, or a Format in Need of Retooling

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