Department of Orthopedics, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
Department of Respiration, Tongji Medical College, Liyuan Hospital, Huazhong University of Science and Technology, Wuhan, China.
Int J Infect Dis. 2024 Nov;148:107225. doi: 10.1016/j.ijid.2024.107225. Epub 2024 Aug 26.
Spondylitis is a spinal infection which has been increasing in susceptible populations globally. This disease is caused by various microorganisms. Fungal spondylitis is rare in clinical practice and is strongly associated with immunosuppression and diabetes. Here, we report a case of suspected ca Melampsora spondylitis.
A patient was suspected with Melampsora spondylitis at the L3-S1 level. The patient received two surgical operations and antifungal treatments. The next-generation sequencing (NGS) analysis of the tissue specimen obtained during the two surgical procedures confirmed the diagnosis of Melampsora spondylitis. The patient was successfully treated with voriconazole, vancomycin, and meropenem following surgical debridement with pedicle screw internal fixation.
The diagnosis of fungal spondylitis is often delayed or missed. Physicians should consider fungal spondylitis in the differential diagnosis of neck pain to facilitate early treatment and prevent spinal cord injury and disability. Although fungal infections often occur in immunocompromised patients, fungal spondylitis has also been reported in immunocompetent patients in recent years. In addition, Candida albicans is usually considered a common bacterium in fungal spondylitis. This case underscores the need to develop more advanced diagnostic and therapeutic techniques to identify the pathogenic bacteria associated with fungal spondylitis besides Candida albicans.
脊柱炎是一种在全球易感人群中不断增加的脊柱感染。这种疾病由各种微生物引起。真菌性脊柱炎在临床上较为罕见，与免疫抑制和糖尿病密切相关。在此，我们报告一例疑似榆叶梅花孢菌脊柱炎。
一名患者在 L3-S1 水平被怀疑患有榆叶梅花孢菌脊柱炎。该患者接受了两次手术和抗真菌治疗。两次手术获得的组织标本的下一代测序（NGS）分析证实了榆叶梅花孢菌脊柱炎的诊断。在进行经皮椎弓根螺钉内固定清创术的同时，给予患者伏立康唑、万古霉素和美罗培南治疗，该患者获得了成功治疗。
真菌性脊柱炎的诊断常常被延误或漏诊。医生在鉴别诊断颈痛时应考虑真菌性脊柱炎，以便早期治疗，防止脊髓损伤和残疾。尽管真菌感染常发生于免疫功能低下的患者，但近年来也有免疫功能正常的患者报告发生真菌性脊柱炎。此外，白色念珠菌通常被认为是真菌性脊柱炎中的常见细菌。本病例强调需要开发更先进的诊断和治疗技术，以确定除白色念珠菌以外与真菌性脊柱炎相关的致病菌。
