From the Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Department of Pediatrics.
Pediatr Infect Dis J. 2019 Feb;38(2):161-163. doi: 10.1097/INF.0000000000002125.
We report the case of a 12-year-old immunocompromised boy with spondylodiscitis of the thoracolumbar spine caused by Aspergillus terreus. Microbiologic diagnosis was confirmed by inoculation of aspiration fluid into blood culture bottles. Because of noncompliance, the patient was treated with extended voriconazole therapy (23 months) with regular serum drug concentration monitoring and intermittent direct observation therapy in an outpatient clinic. The Aspergillus genus contains species that are important causes of morbidity and mortality in immunocompromised hosts. Although the lung is the main target of invasive Aspergillosis, more severe forms such as Aspergillus osteomyelitis can occur. A. fumigatus is the most common cause of Aspergillus osteomyelitis, causing 55%-61% of all cases, whereas A. terreus causes 2.3%-2.8% of cases. The vertebral bodies are the most commonly affected sites, occurring in 46%-49% of cases., Here, we report the case of an immunocompromised 12-year-old boy with thoracolumbar spondylodiscitis caused by A. terreus.
我们报告了一例 12 岁免疫功能低下男孩，由土曲霉引起的胸腰椎脊椎炎。通过将抽吸液接种到血培养瓶中确认了微生物学诊断。由于不遵守规定，该患者接受了延长伏立康唑治疗（23 个月），并定期进行血清药物浓度监测，并在门诊进行间歇性直接观察治疗。曲霉菌属包含在免疫功能低下宿主中发病率和死亡率很高的物种。虽然肺部是侵袭性曲霉菌病的主要靶标，但也可能发生更严重的形式，如曲霉性骨髓炎。烟曲霉是曲霉性骨髓炎最常见的原因，占所有病例的 55%-61%，而土曲霉引起的病例占 2.3%-2.8%。椎体是最常受影响的部位，占 46%-49%。在这里，我们报告了一例由土曲霉引起的免疫功能低下 12 岁男孩的胸腰椎脊椎炎病例。
