Treatment for multiple Aspergillus spondylitis including a hip joint

Area of Science:

• Infectious Diseases
• Neurosurgery
• Orthopedic Surgery

Background:

• Multiple aspergillus spondylitis (AS) is a rare and life-threatening infection, particularly in immunocompromised individuals.
• Limited data exists on the optimal treatment strategies for extensive AS involving multiple spinal levels and joints.
• Aspergillus infections post-transplant pose significant clinical challenges due to host immune status.

Purpose of the Study:

• To report a successful treatment approach for a complex case of multiple aspergillus spondylitis.
• To highlight the combined surgical and antifungal management in a liver transplant recipient.
• To contribute to the limited literature on managing disseminated AS.

Main Methods:

• A 46-year-old liver transplant recipient presented with cervico-thoraco-lumbar spinal and hip aspergillus spondylitis.
• Diagnosis was confirmed via radiologic imaging and pathological examination of biopsy specimens revealing fungal hyphae.
• Treatment involved anterior decompression and interbody fusion for spinal instability and neurological deficits, alongside targeted antifungal therapy.

Main Results:

• The patient experienced successful remission of symptoms following the combined treatment regimen.
• Surgical intervention addressed the instability and neurological compromise caused by the spondylitis.
• Antifungal therapy effectively managed the disseminated Aspergillus infection.

Conclusions:

• Combined surgical management and antifungal therapy can be highly effective for multiple aspergillus spondylitis in immunocompromised patients.
• Aggressive treatment is warranted for disseminated AS to achieve favorable outcomes.
• This case underscores the importance of early diagnosis and multidisciplinary management for post-transplant fungal infections.