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COVID-19 Associated Vertebral Osteomyelitis Caused by Aspergillus Species-A Case Series

Parikshit S Prayag1, Bharat D Purandare1, Sampada A Patwardhan2

  • 1Department of Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, India.

Indian Journal of Orthopaedics
|April 20, 2022
PubMed

Insights

Four non-immunocompromised patients developed Aspergillus vertebral osteomyelitis after COVID-19, often after steroid treatment. This rare fungal infection requires prompt diagnosis and combined treatment.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Orthopedics

Background:

  • Fungal infections, including invasive aspergillosis, are increasingly reported in patients with Coronavirus Disease (COVID-19).
  • Aspergillus osteomyelitis, a rare form of aspergillosis, typically affects immunocompromised individuals.
  • Vertebral osteomyelitis is a serious spinal infection that can be challenging to diagnose.

Observation:

  • This study reports four cases of vertebral osteomyelitis caused by Aspergillus species in patients following COVID-19.
  • Notably, none of the affected patients were immunocompromised.
  • All patients had received corticosteroid therapy during their hospitalization for COVID-19 pneumonitis.

Findings:

  • This is the first description of Aspergillus vertebral osteomyelitis in the post-COVID-19 setting.
  • The findings suggest a potential link between COVID-19, steroid treatment, and the development of this rare fungal bone infection.
  • Diagnosis requires a high index of suspicion and thorough microbiological investigation, extending beyond typical workups for spondylodiscitis.

Implications:

  • Clinicians should consider Aspergillus vertebral osteomyelitis in patients presenting with spondylodiscitis after COVID-19, especially those treated with steroids.
  • Prompt and accurate microbiological diagnosis is crucial for effective management.
  • Combined medical and surgical interventions are generally necessary for successful treatment of Aspergillus osteomyelitis.
Keywords:
Asergillus vertebral osteomyelitisPost COVID

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