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成功治疗免疫功能正常患者的椎骨骨髓炎。

Successful treatment of vertebral osteomyelitis due to in an immunocompetent patient.

机构信息

University of New South Wales, Prince of Wales Clinical School, Randwick, New South Wales, Australia

Infectious Diseases, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.

出版信息

BMJ Case Rep. 2022 Nov 22;15(11):e251101. doi: 10.1136/bcr-2022-251101.

Abstract

Aspergillus osteomyelitis (AO) is a rare and often lethal opportunistic infection in predominantly immunocompromised patients. Treatment has shifted from amphotericin therapy to voriconazole monotherapy due to increased effectiveness and less toxicity. We report a case of an immunocompetent woman with vertebral osteomyelitis due to who was successfully treated with surgery (requiring hardware implantation) and monotherapy posaconazole (following intolerance and hepatitis due to voriconazole). She remained well at follow-up post cessation of 12 months of antifungal therapy. We provide an updated literature review examining the role of azole monotherapy as the gold standard of treatment for AO.

摘要

曲霉菌骨髓炎(AO)是一种罕见且常导致死亡的机会性感染,主要发生于免疫功能低下的患者。由于疗效提高和毒性降低,治疗方法已从两性霉素治疗转变为伏立康唑单药治疗。我们报告了一例免疫功能正常的女性因感染 而患有脊椎骨髓炎的病例,她成功地接受了手术(需要植入硬件)和单药泊沙康唑治疗(因伏立康唑不耐受和肝炎)。在停止 12 个月抗真菌治疗后,她的病情仍保持良好。我们提供了一份最新的文献综述,探讨了唑类单药治疗作为 AO 治疗金标准的作用。

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