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Fungal infections of the spine

Choll W Kim1, Andrew Perry, Brad Currier

  • 1Department of Orthopaedic Surgery, University of California, San Diego, California, USA. chollkim@ucsd.edu

Clinical Orthopaedics and Related Research
|March 9, 2006
PubMed
Abstract

Insights

Fungal spine infections are rare but serious. Early diagnosis and treatment are crucial for managing spinal fungal infections, with surgery sometimes necessary for severe cases.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Mycology

Background:

  • Fungal infections of the spine are uncommon but can cause significant morbidity.
  • Worldwide pathogens like Candida and Aspergillus are common, while geographically limited fungi also exist.
  • Spinal fungal infections can arise from hematogenous spread or direct inoculation, affecting vertebral bodies and leading to complications.

Purpose of the Study:

  • To review the epidemiology, clinical presentation, diagnosis, and management of fungal infections of the spine.
  • To highlight the importance of early recognition and appropriate treatment strategies.
  • To discuss surgical indications and prognostic factors.

Main Methods:

  • This is an expert opinion review (Level V evidence).
  • The review synthesizes current knowledge on spinal fungal infections based on existing literature and clinical experience.

Main Results:

  • Vertebral involvement can lead to compression fractures and deformity.
  • Abscess formation (psoas or paravertebral) can occur along fascial planes.
  • Early diagnosis requires high suspicion, travel history, and physical examination.

Conclusions:

  • Prompt pharmacotherapy and monitoring are key to treatment.
  • Surgical intervention (debridement, fusion) is indicated for treatment resistance, instability, or neurological deficits.
  • Prognosis is influenced by patient health, fungal type, and treatment timeliness.

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