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Case series of aspergillus spondylodiscitis from a tertiary care centre in India

G Vithiya1, S Raja2, M Mariappan3

  • 1Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, India.

Indian Journal of Medical Microbiology
|June 25, 2023
PubMed

Insights

Aspergillus spondylodiscitis, a rare spinal infection, is often misdiagnosed as tuberculosis spine in endemic regions. This case series highlights successful surgical and medical management with voriconazole for Aspergillus spondylodiscitis.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Mycology

Background:

  • Aspergillus spondylodiscitis is a rare spinal infection, frequently misdiagnosed as tuberculosis spine in tuberculosis-endemic areas like India.
  • Early and accurate diagnosis is crucial for effective management and preventing complications.

Observation:

  • This case series reports three patients with chronic low back pain initially diagnosed with tuberculosis spine.
  • Clinical presentation mimicked tuberculous spondylodiscitis, necessitating definitive diagnostic methods.
  • One patient presented with coexisting tuberculosis spine and Aspergillus spondylodiscitis.

Findings:

  • Definitive diagnosis was established through intraoperative culture and histopathological examination of debrided spinal tissue.
  • All patients underwent surgical intervention including debridement, decompression, and spinal fusion.
  • Combined surgical treatment with voriconazole demonstrated successful outcomes in all cases.

Implications:

  • Highlights the importance of considering fungal infections like Aspergillus in the differential diagnosis of spinal infections, especially in endemic regions.
  • Emphasizes the role of microbiological and histopathological analysis for accurate diagnosis.
  • Demonstrates the efficacy of a multimodal treatment approach involving surgery and antifungal therapy (voriconazole) for Aspergillus spondylodiscitis.
Keywords:
AspergillusSpondylodsicitisVoriconazole

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