Department of Spine Surgery, Daping Hospital, Army Medical University, Chongqing, China.
Front Cell Infect Microbiol. 2024 Jan 4;13:1269352. doi: 10.3389/fcimb.2023.1269352. eCollection 2023.
is a fungus responsible for various infections in human beings; however, spine involvement is uncommon. Herein, we report a case of . spondylodiscitis following acupuncture and acupotomy in an immunocompetent Chinese patient. Admission lumbar magnetic resonance imaging (MRI) revealed infection at the L4/5 level without significant vertebral destruction. After unsuccessful symptomatic and anti-tuberculosis treatments, was identified through culture, microscopy of isolate, histological examination and VITEK system. Intravenous voriconazole was then given; however, the patient's spinal condition deteriorated rapidly, resulting in evident destruction of the L4/5 vertebral bodies. Surgeries including L4/5 intervertebral disc debridement, spinal canal decompression, posterior lumbar interbody fusion (PLIF) with allogeneic fibula ring fusion cages, and posterior pedicle screw fixation were then performed. Imaging findings at one-month and six-month follow-up suggested that the patient was successfully treated. This case highlighted two important points: firstly, although acupuncture and acupotomy are generally regarded as safe conservative treatments for pain management, they can still lead to complications such as fungal spinal infection. Therefore, vigilance is necessary when considering these treatments; secondly, PLIF with allogeneic fibula ring fusion cages may be beneficial for spondylodiscitis patients with spinal instability.
是一种可引起人类各种感染的真菌;然而,脊柱受累并不常见。在此,我们报告一例免疫功能正常的中国患者在接受针灸和针刀治疗后发生 。入院时腰椎磁共振成像(MRI)显示 L4/5 水平感染,无明显的椎体破坏。经过不成功的对症和抗结核治疗后,通过培养、分离物的显微镜检查、组织学检查和 VITEK 系统鉴定出 。随后给予静脉伏立康唑治疗;然而,患者的脊柱状况迅速恶化,导致 L4/5 椎体明显破坏。随后进行了包括 L4/5 椎间盘清创术、椎管减压术、后路腰椎体间融合术(PLIF)和同种异体腓骨环融合 cage 、后路椎弓根螺钉固定术。术后 1 个月和 6 个月随访的影像学结果表明患者治疗成功。该病例强调了两个重要要点:首先,虽然针灸和针刀通常被认为是安全的保守治疗疼痛管理方法,但它们仍可导致真菌性脊柱感染等并发症。因此,在考虑这些治疗方法时需要保持警惕;其次,后路腰椎体间融合术联合同种异体腓骨环融合 cage 可能对脊柱不稳定的 脊柱感染患者有益。