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CASE REPORT article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1532282

Aspergillus fumigatus Spondylitis in an Immunocompetent Patient with Annular High Signal Around the Intervertebral Discs: A Case Report and Literature Review

Provisionally accepted
Zhihao Xu Zhihao Xu 1Weijian Zhu Weijian Zhu 2Sirui Zhou Sirui Zhou 3Yuting Zhao Yuting Zhao 4Qi Xiang Qi Xiang 5Yi Zhang Yi Zhang 6*
  • 1 Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
  • 2 Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 3 Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 4 Department of Clinical Laboratory, Wuhan First Hospital, Wuhan, Hubei Province, China
  • 5 Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 6 Wuhan Tongji Aerospace City Hospital, Wuhan, Hebei Province, China

The final, formatted version of the article will be published soon.

    Aspergillus fumigatus spondylitis is a rare fungal infection, primarily occurring in immunocompromised patients, although cases in immunocompetent individuals have also been reported. While Aspergillus fumigatus is commonly associated with pulmonary infections, it can also cause spondylitis. Patients typically present with back pain, limb numbness, and neurological compression symptoms. Imaging findings often show vertebral destruction, reduced disc height, and paraspinal abscesses, potentially accompanied by characteristic ring-enhancing lesions. MRI findings can help distinguish Aspergillus fumigatus spondylitis from other conditions such as tuberculous spondylitis.This case involves an immunocompetent patient with Aspergillus fumigatus spondylitis, whose nonspecific clinical manifestations can easily be confused with other types of spinal infections, leading to a potential misdiagnosis. Diagnosis requires tissue biopsy and microbiological culture. Voriconazole is the first-line antifungal agent, and studies have shown that it improves patient response and survival rates. For patients with significant spinal compression or neurological symptoms, surgical intervention combined with antifungal treatment should be considered if antifungal therapy alone is ineffective.Although Aspergillus fumigatus spondylitis is rare, it can occur in immunocompetent individuals. Early diagnosis through imaging and biopsy is crucial, and a combination of surgery and antifungal therapy can help improve prognosis.

    Keywords: Aspergillus fumigatus, Aspergillus, Infectious spondylitis, Immunocompetent, Clinical features

    Received: 26 Nov 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Xu, Zhu, Zhou, Zhao, Xiang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yi Zhang, Wuhan Tongji Aerospace City Hospital, Wuhan, Hebei Province, China

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