Spondylodiscitis Caused by Species.

BACKGROUND

Spondylodiscitis caused by spp. is a rare but life-threatening clinical entity. However, a consensus on diagnostic criteria and most effective medical management is still missing. The present study is a review of all published cases of spondylodiscitis caused by spp., in an effort to elucidate epidemiology, patients' characteristics, andand the medical and surgical treatment options and their effectiveness.

METHODS

A thorough review of all existing spondylodiscitis cases caused by was performed. Data regarding demographics, responsible fungus, time between symptoms' onset and firm diagnosis, antifungal treatment (AFT), surgical intervention, andand the infection's outcome were investigated.

RESULTS

A total of 118 spondylodiscitis cases, yielding 119 spp. isolates, were identified in the literature. The patients' mean age was 40.6 years. Magnetic resonance imaging (MRI) (after its introduction) indicated the diagnosis in most cases (66.7%), while definite diagnosis was established through cultures in the majority of cases (73.7%). was isolated in most cases (73; 61.3%), followed by (15; 12.6%) andand and (7; 5.9%, each). The mean time between symptoms' onset and diagnosis was 5.7 months. Amphotericin B was the preferred antifungal regiment (84 cases; 71.2%), followed by voriconazole (31; 26.3%), and the mean AFT duration was 6.1 months. The final outcome was successful in 93 cases (78.8%). Furthermore, 77 patients (65.3%) underwent surgery.

CONCLUSIONS

Spondylodiscitis caused by spp. represents a clinical challenge, requiring a multidisciplinary approach. The present review has shown that prolonged AFT has been the standard of care of the studied cases, while surgical treatment seems to play an important role in selected patents.