Khalil Mohammad O, Ayasa Laith A, Odeh Anas, Alawadhi Husain
Faculty of Medicine, Al-Quds University, Jerusalem, PSE.
Internal Medicine, Al-Quds University, Jerusalem, PSE.
Cureus. 2023 Jul 18;15(7):e42079. doi: 10.7759/cureus.42079. eCollection 2023 Jul.
We present a case of a 57-year-old male patient with a history of prolonged intensive care unit (ICU) stay for coronavirus disease 2019 (COVID-19) who developed fungal spondylodiscitis, a rare complication. The patient initially presented complaining of respiratory symptoms and was subsequently treated with tocilizumab, remdesivir, enoxaparin, and dexamethasone. Following ICU discharge, he experienced recurrent infections, including extended-spectrum beta-lactamase urinary tract infection. Two months later, he developed back pain; magnetic resonance imaging (MRI) revealed inflammatory spondylodiscitis. Despite empirical antibiotic therapy, his condition did not improve, and a bone biopsy confirmed infection. Antifungal treatment with fluconazole and anidulafungin resulted in a significant clinical improvement. The patient achieved complete recovery after six months of therapy. This case highlights the rare occurrence of fungal spondylodiscitis in COVID-19 patients with a history of ICU stay and emphasizes the importance of early recognition and appropriate management to mitigate potential complications.
我们报告一例57岁男性患者,该患者因2019冠状病毒病(COVID-19)在重症监护病房(ICU)长期住院,之后发生了真菌性脊椎椎间盘炎,这是一种罕见的并发症。患者最初因呼吸道症状就诊,随后接受了托珠单抗、瑞德西韦、依诺肝素和地塞米松治疗。从ICU出院后,他经历了反复感染,包括产超广谱β-内酰胺酶尿路感染。两个月后,他出现背痛;磁共振成像(MRI)显示为炎性脊椎椎间盘炎。尽管进行了经验性抗生素治疗,但其病情并未改善,骨活检确诊为感染。使用氟康唑和阿尼芬净进行抗真菌治疗后,临床症状有显著改善。经过六个月的治疗,患者完全康复。该病例凸显了在有ICU住院史的COVID-19患者中罕见发生真菌性脊椎椎间盘炎的情况,并强调了早期识别和适当管理以减轻潜在并发症的重要性。