Metagenomic next-generation sequencing enabled diagnosis of spondylitis in an immunocompetent patient: a case report and literature review.

BACKGROUND

spondylitis is a rare fungal spondylitis that often occurs in immunocompromised patients. This article reports a case of spondylitis with specific image signs, which is rarely reported in an immunocompetent patient.

CASE PRESENTATION

This is a case of L3-4 segmental spondylitis diagnosed. The diagnosis was confirmed by intraoperative metagenomic next-generation sequencing (mNGS) testing of the diseased tissue. The patient was treated with voriconazole and underwent surgical debridement and internal fixation with pedicle screws.

CONCLUSION

The diagnosis of spondylitis is often delayed or missed. Doctors should consider spondylitis in the differential diagnosis of unexplained low back pain so that appropriate treatment can be administered to prevent spinal cord injury and disability. spondylitis usually results in endplate inflammatory response line on fluid or enhancement sequences and a diffuse low signal in the diseased vertebral body on T2-weighted imaging (T2WI). It also results in large paraspinal abscesses, which requires further research to better differentiate between spondylitis and tuberculous spondylitis. Prompt diagnosis and treatment can improve the patient's prognosis.