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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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Melampsora spondylitis presenting with unexplained low back pain: A case report
Weijian Zhu1, Sirui Zhou2, Zhihao Xu3
1Department of Orthopedics, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
Summary
Fungal spondylitis, a rare spinal infection, is increasingly reported. Early diagnosis and advanced treatments are crucial for managing this condition, especially in non-immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Mycology
- Spinal Surgery
Background:
- Spondylitis, a spinal infection, is rising globally, with fungal causes being rare but serious.
- Fungal spondylitis is often linked to immunosuppression and diabetes, but can occur in immunocompetent individuals.
- Delayed diagnosis of fungal spondylitis can lead to severe neurological deficits and disability.
Observation:
- A case of suspected fungal spondylitis at the L3-S1 spinal level is presented.
- Next-generation sequencing (NGS) confirmed the diagnosis of Melampsora spondylitis.
- The patient underwent surgical debridement with internal fixation and received antifungal and antibiotic treatment.
Findings:
- Successful treatment of Melampsora spondylitis was achieved with voriconazole, vancomycin, and meropenem.
- This case highlights the importance of considering fungal pathogens beyond Candida albicans in spondylitis.
- The diagnosis of fungal spondylitis was confirmed via NGS analysis of surgical specimens.
Implications:
- Physicians should include fungal spondylitis in the differential diagnosis for spinal infections, even in immunocompetent patients.
- Advanced diagnostic tools like NGS are vital for identifying rare fungal pathogens causing spondylitis.
- Developing novel therapeutic strategies is essential for improving outcomes in fungal spondylitis.
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