Teigell Muñoz Francisco Javier, Sánchez-de Torre Ana, Jiménez-Fernández Marta, Zuñiga Gómez Lorenzo, Mateos-González María, Batiray Polat Abdulhamit, Fortún Abete Jesús
Internal Medicine Department, Infanta Cristina University Hospital, Madrid, Spain.
Medical Oncology Department, Infanta Cristina University Hospital, Madrid, Spain.
J Infect Chemother. 2025 Feb;31(2):102567. doi: 10.1016/j.jiac.2024.11.017. Epub 2024 Nov 28.
We present a case of spondylodiscitis caused by Aspergillus fumigatus, which we successfully treated with isavuconazole after voriconazole severe intolerance. Aspergillus spondylodiscitis is a severe and relatively rare form of extra-pulmonary invasive aspergillosis. Typically, voriconazole is the first-choice antifungal drug for treating Aspergillus osteomyelitis or spondylodiscitis. However, isavuconazole, a new antifungal medication, has been demonstrated as non-inferior to voriconazole in cases of invasive aspergillosis. It has the added benefits of fewer hepatobiliary, ocular, and cutaneous side effects. It generally does not demand serum level monitoring and poses fewer risks of drug interactions. Nonetheless, there are no studies yet that support its use in spondylodiscitis, and published experiences are very limited and based on isolated cases, albeit mainly positive. The case we present here aims to provide additional evidence on the efficacy and tolerability of isavuconazole in treating this condition.
我们报告一例由烟曲霉引起的脊椎椎间盘炎病例，在伏立康唑严重不耐受后，我们用艾沙康唑成功治疗了该病例。曲霉性脊椎椎间盘炎是肺外侵袭性曲霉病的一种严重且相对罕见的形式。通常，伏立康唑是治疗曲霉性骨髓炎或脊椎椎间盘炎的首选抗真菌药物。然而，艾沙康唑作为一种新型抗真菌药物，在侵袭性曲霉病病例中已被证明不劣于伏立康唑。它还有额外的好处，即肝胆、眼部和皮肤副作用较少。它一般不需要监测血清水平，药物相互作用的风险也较小。尽管如此，目前尚无研究支持其在脊椎椎间盘炎中的应用，已发表的经验非常有限且基于个别病例，尽管主要是积极的。我们在此呈现的病例旨在为艾沙康唑治疗这种疾病的疗效和耐受性提供更多证据。
