D'Hoore K, Hoogmartens M
Department of Orthopaedic Surgery, University Hospital Pellenberg, Katholieke Universiteit Leuven, Belgium.
Acta Orthop Belg. 1993;59(3):306-14.
A case of Aspergillus osteomyelitis of the spine is presented and the world literature is reviewed, for a total of 32 cases. Aspergillus osteomyelitis is rare, but the spine is most frequently affected. It can be induced hematogenously, by contiguity or by direct inoculation. Up to now medical treatment has been based on amphotericin B, but its toxicity is problematic. Itraconazole and fluconazole do not have this shortcoming. Additional surgery has been advocated in the past. In the present series combined medical-surgical treatment (20 cases) led to a higher survival rate (70%) than medical treatment (12 cases: 58%), but neurological recovery was much more frequent in the second group (40% versus 13%).
本文报告了一例脊柱曲霉菌骨髓炎病例，并对世界文献进行了综述，共32例。曲霉菌骨髓炎较为罕见，但脊柱是最常受累的部位。它可通过血行播散、邻近组织蔓延或直接接种引起。到目前为止，药物治疗一直以两性霉素B为基础，但它的毒性存在问题。伊曲康唑和氟康唑没有这个缺点。过去曾提倡进行额外的手术。在本系列中，综合药物-手术治疗（20例）的生存率（70%）高于单纯药物治疗（12例：58%），但第二组神经功能恢复更为常见（40%对13%）。
