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Aspergillus discitis with acute disc abscess
W Assaad1, P S Nuchikat, L Cohen
1Department of Internal Medicine, Northeastern Ohio Universities College of Medicine, Canton.
Study Design:
Aspergillus osteomyelitis of the vertebral body and disc space is rare. This report discusses a case that occurred in an immunosuppressed 29-year-old man and reviews the pertinent medical literature.
Objectives:
To review the management and treatment of Aspergillus osteomyelitis of the vertebral body and disc space.
Summary Of Background Data:
The patient presented with acute neurologic compromise resulting from L5-S1 discitis and a large epidural soft tissue component secondary to the Aspergillus infection.
Results:
The patient underwent aggressive surgical debridement along with treatment with amphotericin B and had a complete clinical recovery.
Conclusions:
The authors recommend a combined medical-surgical approach in most cases of vertebral Aspergillus osteomyelitis. Early surgery with vigorous surgical debridement along with antifungal treatment seems to yield a good outcome.
Insights
Aspergillus osteomyelitis, a rare vertebral infection, requires aggressive surgical debridement and antifungal treatment for successful outcomes. This case highlights a combined medical-surgical approach for effective management of spinal fungal infections.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Mycology
Background:
- Vertebral osteomyelitis caused by Aspergillus is exceptionally rare.
- This case involves an immunocompromised 29-year-old male with Aspergillus osteomyelitis affecting the L5-S1 vertebral body and disc space.
- The patient presented with acute neurologic compromise due to discitis and an epidural abscess.
Observation:
- The patient experienced acute neurologic compromise.
- Diagnosis was confirmed as Aspergillus osteomyelitis of the lumbar spine.
- A large epidural soft tissue component was noted secondary to the infection.
Findings:
- The patient underwent aggressive surgical debridement.
- Treatment included amphotericin B, an antifungal medication.
- Complete clinical recovery was achieved post-treatment.
Implications:
- A combined medical-surgical approach is recommended for vertebral Aspergillus osteomyelitis.
- Early surgical intervention with thorough debridement, alongside antifungal therapy, is crucial for favorable outcomes.
- This case underscores the importance of prompt and aggressive management for rare spinal fungal infections.