Postoperative initial single fungal discitis progressively spreading to adjacent multiple segments after lumbar...

Area of Science:

• Spinal surgery
• Infectious diseases
• Mycology

Background:

• Fungal spondylodiscitis is a rare but serious complication following spinal surgery.
• Postoperative fungal discitis can present as a single segment infection that progresses to multiple spinal involvements.

Purpose of the Study:

• To investigate the etiology and clinical course of fungal spondylodiscitis after lumbar discectomy.
• To report on cases of fungal spondylodiscitis that spread to adjacent spinal segments.

Main Methods:

• Retrospective analysis of ten adult patients with postoperative fungal discitis from January 2005 to May 2013.
• Confirmation of fungal infection through microbiologic and pathologic examinations.
• Investigation of clinical presentation, radiographic findings, and treatment outcomes.

Main Results:

• Fungal spondylodiscitis developed in previously healthy patients, with symptoms appearing a median of 61 days post-surgery.
• Despite surgical debridement and antifungal therapy, infection spread to adjacent discs in some cases.
• All patients achieved complete resolution with prolonged antifungal treatment and spontaneous fusion, with no mortality or severe neurological deficits.

Conclusions:

• Fungal spondylodiscitis post-surgery is a challenging complication that may not be halted by surgical debridement alone.
• Insufficient antifungal treatment duration can lead to infection progression.
• Prolonged antifungal therapy and infectious disease specialist consultation are essential for managing fungal spondylodiscitis.