Garcia-Vidal Carolina, Cabellos Carmen, Ayats Josefina, Font Frederic, Ferran Enrique, Fernandez-Viladrich Pedro
Infectious Disease Service, IDIBELL-Hospital Universitary de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
Spine J. 2009 Sep;9(9):e1-7. doi: 10.1016/j.spinee.2009.03.012. Epub 2009 May 17.
Postoperative fungal spondylodiscitis is a rare infectious disease.
We report the first case of postoperative spondylodiscitis because of Scedosporium prolificans and review postoperative vertebral infection caused by fungi.
STUDY DESIGN/SETTING: Medline search.
Case report and literature review.
On reviewing the cases of postoperative fungal spondylodiscitis reported so far in the literature, we found eight were caused by mold, and five by yeast. Clinically, the disease presents similar to postoperative vertebral osteomyelitis caused by bacteria, and a high clinical index of suspicion may be required to perform appropriate cultures to establish a diagnosis. Our review revealed a significant number of cases that were cured after surgical debridement and/or antifungal therapy.
On the basis of this limited assessment, it appears that the clinical course and prognosis of postoperative fungal spondylodiscitis is similar to that reported for postoperative pyogenic spondylodiscitis.
术后真菌性脊椎椎间盘炎是一种罕见的感染性疾病。
我们报告首例由多育赛多孢菌引起的术后脊椎椎间盘炎病例，并回顾真菌引起的术后椎体感染情况。
研究设计/研究背景：医学文献检索。
病例报告及文献回顾。
回顾文献中迄今报道的术后真菌性脊椎椎间盘炎病例，我们发现8例由霉菌引起，5例由酵母菌引起。临床上，该疾病的表现与细菌引起的术后椎体骨髓炎相似，可能需要较高的临床怀疑指数才能进行适当的培养以确诊。我们的回顾显示，大量病例在手术清创和/或抗真菌治疗后治愈。
基于这一有限的评估，术后真菌性脊椎椎间盘炎的临床病程和预后似乎与术后化脓性脊椎椎间盘炎的报道相似。
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