Reed Thomas A N, Shtaya Anan, Beard Kate, Saeed Kordo, Glover Sarah, Fabian Mark, Baraka Mohammad, McGillion Stephen
NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Infez Med. 2023 Mar 1;31(1):108-112. doi: 10.53854/liim-3101-15. eCollection 2022.
vertebral osteomyelitis causing deformity in immunocompetent patients is uncommon. We describe a previously healthy 68-year-old male who was referred after 2 years of lower thoracic back pain and gibbus. His inflammatory markers and HIV test were normal. Imaging demonstrated bony destruction of T12/L1 and L2 with vertebral collapse. Following inconclusive CT-guided biopsy, he underwent reconstructive spinal surgery. Histopathology showed fungi and was cultured. He was treated with isavuconazole 200 mg once daily for 12 months with a satisfactory clinical outcome. We present a summary of recently published cases of atraumatic Aspergillus vertebral osteomyelitis in immunocompetent patients without risk factors. Fungal infection should be considered in culture-negative spondylodiscitis, even in the absence of risk factors.
免疫功能正常的患者中,由脊椎骨髓炎导致畸形的情况并不常见。我们描述了一位既往健康的68岁男性,他在出现下胸背部疼痛和脊柱后凸2年后前来就诊。他的炎症指标和HIV检测均正常。影像学检查显示T12/L1和L2椎体骨质破坏并伴有椎体塌陷。在CT引导下活检结果不明确后,他接受了脊柱重建手术。组织病理学检查发现真菌并进行了培养。他接受了每日一次200毫克的艾沙康唑治疗,疗程为12个月,临床结果令人满意。我们总结了近期发表的无危险因素的免疫功能正常患者非创伤性曲霉菌性脊椎骨髓炎病例。即使在没有危险因素的情况下,对于培养阴性的脊椎间盘炎也应考虑真菌感染。