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Spinal aspergillus osteomyelitis.

F C Vinas1, P K King, F G Diaz

  • 1Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. vinas@neurosurg.wayne.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 18, 1999
PubMed
Summary
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Vertebral aspergillosis, a rare bone infection, often affects the lumbar spine, particularly in middle-aged men. Corticosteroid use is a key risk factor, with significant recovery rates but notable mortality.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Orthopedic Surgery

Background:

  • Vertebral osteomyelitis is typically caused by bacteria, with fungal infections like aspergillosis being uncommon.
  • Corticosteroid use is increasingly recognized as a predisposing factor for opportunistic infections.

Observation:

  • This study reviews 39 cases of vertebral aspergillosis, with two additional cases involving lumbar vertebrae.
  • The condition predominantly affects middle-aged males, with lumbar spine involvement being most frequent.
  • Back pain is the primary symptom, and predisposing factors are present in a majority of patients.

Findings:

  • Monomicrobial Aspergillus infections were observed in most cases.
  • Elevated white blood cell counts and erythrocyte sedimentation rates were noted in a subset of patients.

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  • The overall recovery rate was 68.3%, with a mortality rate of 26.8%.

    • Implications:

    • Early recognition and diagnosis of vertebral aspergillosis are crucial, especially in patients with risk factors like corticosteroid use.
    • While medical management is primary, surgical intervention may be necessary in severe or refractory cases.
    • Further research into optimal treatment strategies for this rare but serious infection is warranted.