Spinal Mucormycosis with MRSA Superinfection in a Diabetic Female: A Rare and Lethal Encounter

Spinal infections due to fungi are uncommon, representing less than 2% of all spinal infection cases. Among these, mucormycosis is exceptionally rare, with only 15 cases reported in the English literature to date.

We present the case of a 55-year-old woman with poorly controlled diabetes mellitus who developed low back pain, bilateral radiculopathy, and progressive neurological decline. Imaging revealed L5-S1 discitis with paraspinal and epidural abscess. She underwent surgical debridement and stabilization. Microbiological analysis of intraoperative samples initially confi rmed methicillin-resistant Staphylococcus aureus (MRSA), followed by growth of Mucor racemosus on fungal culture. Despite aggressive antifungal therapy with liposomal amphotericin B, surgical re-exploration, and multidisciplinary intensive care, the patient succumbed to sepsis and cardiac arrest on postoperative day 33.

To our knowledge, this is the fi rst reported case of dual infection with MRSA and spinal mucormycosis. This case highlights the importance of early fungal cultures, prompt antifungal initiation, and a multidisciplinary approach in immunocompromised patients.