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Updated: Oct 16, 2025
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
Spondylodiscitis Caused by Aspergillus Species
Christos Koutserimpas1, Ifigeneia Chamakioti1, Symeon Naoum1
1Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, 115 25 Athens, Greece.
Background:
Spondylodiscitis caused by Aspergillus spp. is a rare but life-threatening clinical entity. However, a consensus on diagnostic criteria and most effective medical management is still missing. The present study is a review of all published cases of spondylodiscitis caused by Aspergillus spp., in an effort to elucidate epidemiology, patients' characteristics, andand the medical and surgical treatment options and their effectiveness.
Methods:
A thorough review of all existing spondylodiscitis cases caused by Aspergillus was performed. Data regarding demographics, responsible fungus, time between symptoms' onset and firm diagnosis, antifungal treatment (AFT), surgical intervention, andand the infection's outcome were investigated.
Results:
A total of 118 Aspergillus spondylodiscitis cases, yielding 119 Aspergillus spp. isolates, were identified in the literature. The patients' mean age was 40.6 years. Magnetic resonance imaging (MRI) (after its introduction) indicated the diagnosis in most cases (66.7%), while definite diagnosis was established through cultures in the majority of cases (73.7%). Aspergillus fumigatus was isolated in most cases (73; 61.3%), followed by Aspergillus flavus (15; 12.6%) andand Aspergillus nidulans and terreus (7; 5.9%, each). The mean time between symptoms' onset and diagnosis was 5.7 months. Amphotericin B was the preferred antifungal regiment (84 cases; 71.2%), followed by voriconazole (31; 26.3%), and the mean AFT duration was 6.1 months. The final outcome was successful in 93 cases (78.8%). Furthermore, 77 patients (65.3%) underwent surgery.
Conclusions:
Spondylodiscitis caused by Aspergillus spp. represents a clinical challenge, requiring a multidisciplinary approach. The present review has shown that prolonged AFT has been the standard of care of the studied cases, while surgical treatment seems to play an important role in selected patents.
Insights
Aspergillus spondylodiscitis is a rare fungal infection of the spine. This review highlights prolonged antifungal treatment as standard care, with surgery beneficial in select cases for better outcomes.
Area of Science:
- Infectious Diseases
- Mycology
- Spinal Surgery
Background:
- Spondylodiscitis caused by Aspergillus species is a rare, life-threatening condition.
- Lack of consensus on diagnostic criteria and optimal medical management.
- This study reviews published cases to elucidate epidemiology, patient characteristics, and treatment effectiveness.
Purpose of the Study:
- To review and analyze all published cases of Aspergillus spondylodiscitis.
- To understand the epidemiology and patient demographics.
- To evaluate the effectiveness of medical and surgical treatment options.
Main Methods:
- Comprehensive literature review of Aspergillus spondylodiscitis cases.
- Data extraction on demographics, causative Aspergillus species, diagnosis timelines, antifungal treatment (AFT), and surgical interventions.
- Analysis of treatment outcomes.
Main Results:
- 118 cases identified; mean patient age 40.6 years.
- Magnetic resonance imaging (MRI) and cultures were key diagnostic tools.
- Aspergillus fumigatus was the most common species; Amphotericin B was the preferred antifungal treatment.
- Successful outcomes in 78.8% of cases, with 65.3% undergoing surgery.
Conclusions:
- Aspergillus spondylodiscitis presents a significant clinical challenge requiring a multidisciplinary approach.
- Prolonged antifungal therapy is the established standard of care.
- Surgical intervention plays a crucial role in managing selected patients.
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