Aspergillus spondylitis: case series and literature review
- PDF / 2,179,817 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 27 Downloads / 213 Views
RESEARCH ARTICLE
Open Access
Aspergillus spondylitis: case series and literature review Guohua Dai, Ting Wang*, Chuqiang Yin, Yuanliang Sun, Derong Xu, Zhongying Wang, Liangrui Luan, Jianwen Hou and Shuzhong Li*
Abstract Background: Spinal fungal infections, especially spinal Aspergillus infections, are rare in the clinic. Here, we introduce the clinical features, diagnosis, treatment, and prognoses of 6 cases of Aspergillus spondylitis. Methods: We retrospectively analysed the complete clinical data of patients with Aspergillus spondylitis treated in our hospital from January 2013 to January 2020. Results: Aspergillus fumigatus was isolated in 4 cases, and Aspergillus spp. and Aspergillus niger were isolated in 1 case each. All six patients reported varying degrees of focal spinal pain; one patient reported radiating pain, one patient experienced bowel dysfunction and numbness in both lower limbs, and three patients had fever symptoms. One case involved the thoracic spine, one case involved the thoracolumbar junction, and 4 cases involved the lumbar spine. Three patients were already in an immunosuppressed state, and three patients entered an immunosuppressed state after spinal surgery. All six patients were successfully cured, and five required surgery. Of the 5 patients who underwent surgical treatment, 2 had spinal cord compression symptoms, and 3 had spinal instability. At the end of follow-up, 1 patient reported left back pain and 1 patient reported left limb numbness. Conclusion: The clinical manifestations of Aspergillus spondylitis are non-specific, and the diagnosis depends on typical imaging findings and microbiological and histopathological examination results. When there is no spinal instability, spinal nerve compression symptoms, or progressive deterioration, antifungal therapy alone may be considered. If spinal instability, spinal nerve compression, or epidural abscess formation is present, surgery combined with antifungal therapy is recommended. Keywords: Aspergillus spondylitis, Clinical features, Diagnosis and treatment, Prognosis
Background Aspergillus is a saprophytic fungus that mainly inhabits soil and plants [1]. Aspergillosis is an opportunistic infection that mainly affects the respiratory tract and can be spread through blood contact [2]. Severe neutropenia, glucocorticoid use, transplantation and other immunosuppressive conditions may lead to invasive infections [3]. Aspergillus infection can occur in most organs, but * Correspondence: [email protected]; [email protected] Department of Spine Surgery, Affiliated Hospital of Qingdao University, 16 jiangsu road, Shinan District, Qingdao City Post Code: 266000, Shandong Province, China
the lung is the main target organ. Among extrapulmonary infections, approximately 1.82% involve the skeletal muscle system [4], and of those, approximately half involve the spine [5–7]. Due to its potentially delayed onset and non-specific clinical manifestations, it is often misdiagnosed at initial presentation [8]. This study retrospectively analy
Data Loading...
