Hummel M, Schüler S, Weber U, Schwertlick G, Hempel S, Theiss D, Rees W, Mueller J, Hetzer R
German Heart Institute Berlin, Division of Thoracic and Cardiovascular Surgery.
J Heart Lung Transplant. 1993 Jul-Aug;12(4):599-603.
This is the report of a 49-year-old man, who could be cured of aspergillosis with Aspergillus osteomyelitis and diskitis of the lumbar spine by medical and surgical therapy after heart retransplantation. Aspergillus osteomyelitis and diskitis is a rare complication of invasive aspergillosis. Lumbar involvement is the main manifestation, followed by rare locations in the tibia, ribs, wrist, sternum, pelvis, and knee. It is nearly always secondary to pulmonary aspergillosis, which occurs in about 6% to 14% of patients after heart transplantation. For treatment, a combined surgical and medical approach is recommended, which enables quick pain relief for the patient and histologic and microbiologic diagnosis and stabilization of the spine. Because of definitive cure of osteomyelitis cannot be guaranteed by removal of the abscess, medical therapy after surgery is necessary for years.
这是一名49岁男性的病例报告，该患者在心脏再次移植后，通过药物和手术治疗治愈了患有曲霉菌性骨髓炎和腰椎间盘炎的曲霉病。曲霉菌性骨髓炎和椎间盘炎是侵袭性曲霉病的一种罕见并发症。腰椎受累是主要表现，其次是胫骨、肋骨、腕部、胸骨、骨盆和膝部等罕见部位。它几乎总是继发于肺曲霉病，肺曲霉病在心脏移植后的患者中发生率约为6%至14%。对于治疗，建议采用手术和药物联合治疗方法，这能使患者迅速缓解疼痛，并进行组织学和微生物学诊断以及稳定脊柱。由于切除脓肿不能保证骨髓炎得到根治，术后需要进行数年的药物治疗。
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